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Multicenter Study
. 2021 Dec;6(6):100316.
doi: 10.1016/j.esmoop.2021.100316. Epub 2021 Dec 1.

Lymphovascular invasion has a significant prognostic impact in patients with early breast cancer, results from a large, national, multicenter, retrospective cohort study

G Houvenaeghel  1 , M Cohen  2 , J M Classe  3 , F Reyal  4 , C Mazouni  5 , N Chopin  6 , A Martinez  7 , E Daraï  8 , C Coutant  9 , P E Colombo  10 , P Gimbergues  11 , M P Chauvet  12 , A S Azuar  13 , R Rouzier  14 , C Tunon de Lara  15 , X Muracciole  16 , A Agostini  17 , M Bannier  2 , E Charaffe Jauffret  18 , A De Nonneville  19 , A Goncalves  19
Affiliations
Multicenter Study

Lymphovascular invasion has a significant prognostic impact in patients with early breast cancer, results from a large, national, multicenter, retrospective cohort study

G Houvenaeghel et al. ESMO Open. 2021 Dec.

Abstract

Background: We determined the prognostic impact of lymphovascular invasion (LVI) in a large, national, multicenter, retrospective cohort of patients with early breast cancer (BC) according to numerous factors.

Patients and methods: We collected data on 17 322 early BC patients treated in 13 French cancer centers from 1991 to 2013. Survival functions were calculated using the Kaplan-Meier method and multivariate survival analyses were carried out using the Cox proportional hazards regression model adjusted for significant variables associated with LVI or not. Two propensity score-based matching approaches were used to balance differences in known prognostic variables associated with LVI status and to assess the impact of adjuvant chemotherapy (AC) in LVI-positive luminal A-like patients.

Results: LVI was present in 24.3% (4205) of patients. LVI was significantly and independently associated with all clinical and pathological characteristics analyzed in the entire population and according to endocrine receptor (ER) status except for the time period in binary logistic regression. According to multivariate analyses including ER status, AC, grade, and tumor subtypes, the presence of LVI was significantly associated with a negative prognostic impact on overall (OS), disease-free (DFS), and metastasis-free survival (MFS) in all patients [hazard ratio (HR) = 1.345, HR = 1.312, and HR = 1.415, respectively; P < 0.0001], which was also observed in the propensity score-based analysis in addition to the association of AC with a significant increase in both OS and DFS in LVI-positive luminal A-like patients. LVI did not have a significant impact in either patients with ER-positive grade 3 tumors or those with AC-treated luminal A-like tumors.

Conclusion: The presence of LVI has an independent negative prognostic impact on OS, DFS, and MFS in early BC patients, except in ER-positive grade 3 tumors and in those with luminal A-like tumors treated with AC. Therefore, LVI may indicate the existence of a subset of luminal A-like patients who may still benefit from adjuvant therapy.

Keywords: breast cancer; luminal A subtype; lymphovascular invasion; multicenter study.

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Conflict of interest statement

Disclosure The authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves demonstrating (A) disease-free survival, (B) metastasis-free survival, and (C) overall survival, according to the presence of lymphovascular invasion (LVI).
Figure 2
Figure 2
Kaplan–Meier curves demonstrating (A) overall survival, (B) disease-free survival, and (C) metastasis-free survival, according to the presence of lymphovascular invasion (LVI), in the matched cohort.
See this image and copyright information in PMC

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