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Volume 10 Supplement 2

Breast Cancer Research 2008

Lymphovascular invasion in breast cancer: improved methods of detection and clinical significance

Breast Cancer Research volume 10, Article number: P72 (2008) Cite this article

Background

The presence of vascular invasion (VI), encompassing both lymphovascular invasion (LVI) and blood vascular invasion (BVI), in breast cancer has been found to be a poor prognostic factor. It is not clear, however, which type plays the major role in metastasis.

Methods

To distinguish between LVI and BVI, sections from 177 consecutive paraffin-embedded specimens of primary breast cancers, with known long-term follow-up, were immunohistochemically stained with two blood vascular markers (CD34 and CD31) and with a lymphatic marker (podoplanin/D2-40). BVI and LVI were identified and the results correlated with clinicopathological criteria and patient survival.

Results

VI was detected in 56/177 specimens (32%); 54 (96%) were LVI and two (4%) were BVI. The presence of LVI was significantly associated with the presence of LN metastasis, development of distant metastasis, regional recurrence, and a worse disease-free interval and overall survival. In multivariate analysis, LVI retained a significant association with decreased disease-free interval and overall survival. When assessment of LVI using H&E was compared using the lymphatic marker, VI was missed in 30/177 (16.9%) and was falsely positive in 12/177 (6.8%) using H&E.

Conclusion

VI in breast cancer is predominantly of lymph vessels and is a powerful independent prognostic factor. The use of immunohistochemical staining with podoplanin/D2-40 increases the accuracy of identification.

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Affiliations

  1. Clinical Oncology Department, University of Nottingham, University Hospitals, City Hospital Campus, Nottingham, UK

    RAA Mohammed & SG Martin

  2. Histopathology Department, University of Nottingham, University Hospitals, City Hospital Campus, Nottingham, UK

    RAA Mohammed, MS Gill, EC Paish & IO Ellis

  3. Division of Pathology School of Molecular Medical Sciences, University of Nottingham Queen's Medical Centre, Nottingham, UK

    AR Green

Authors
  1. RAA Mohammed
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  2. SG Martin
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  3. MS Gill
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  4. AR Green
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  5. EC Paish
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  6. IO Ellis
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Cite this article

Mohammed, R., Martin, S., Gill, M. et al. Lymphovascular invasion in breast cancer: improved methods of detection and clinical significance. Breast Cancer Res 10, P72 (2008). https://doi.org/10.1186/bcr1956

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Keywords

  • Breast Cancer
  • Prognostic Factor
  • Clinical Significance
  • Distant Metastasis
  • Patient Survival

Breast Cancer Research

ISSN: 1465-542X

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