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Is it useful to detect lymphovascular invasion in lymph node‐positive patients with primary operable breast cancer?
Author(s) -
Ragage Florence,
Debled Marc,
MacGrogan Gaëtan,
Brouste Véronique,
Desrousseaux Marie,
Soubeyran Isabelle,
Tu de Lara Christine,
Mauriac Louis,
de Mascarel Isabelle
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25137
Subject(s) - medicine , lymphovascular invasion , breast cancer , lymph node , oncology , cancer , estrogen receptor , lymph , metastasis , pathology
BACKGROUND: Lymphovascular invasion (LVI) is a widely recognized prognostic factor in lymph node‐negative breast cancers. However, there are only limited and controversial data about its prognostic significance in lymph node‐positive patients. METHODS: Among 931 patients operated on and monitored at the authors' institution for an invasive breast carcinoma between 1989 and 1992, all 374 lymph node‐positive breast cancers entered the study (median follow‐up, 126 months). RESULTS: LVI was present in 46% of tumors and was associated with age ≤40 years ( P = .02), high histological grade ( P = .01), and negative estrogen receptor status ( P = .032), but not with tumor size, number of involved lymph nodes, or HER‐2/ neu status. LVI was an independent prognostic factor for distant metastases ( P = .002). Furthermore, in HER‐2/ neu –negative/hormone receptor‐positive (n = 287) tumors, the number of independent prognostic factors (LVI, age, histological grade, number of involved lymph nodes, and tumor size) was associated with a 5‐years metastasis‐free survival ranging from 100% if no factors (n = 25) to 89% ± 2% if 1 or 2 factors (n = 186) and 67% ± 6 if 3, 4, or 5 factors (n = 76) were present ( P < .001). CONCLUSIONS: LVI is an independent prognostic factor in lymph node‐positive breast cancer and merits further prospective investigations as a decision tool in the adjuvant chemotherapy setting. Cancer 2010. © 2010 American Cancer Society.