Clinicopathologic factor and Lymphovascular Invasion in Breast cancer

Ja Seong Bae; Byung Joo Song; Mi la Kim; Seok Hyo Chang; Han Seong Kim; Woo Chan Park; Jeong Soo Kim; Sang Seol Jung

doi:10.4048/jbc.2006.9.4.317

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Bae, Song, Kim, Chang, Kim, Park, Kim, and Jung: Clinicopathologic factor and Lymphovascular Invasion in Breast cancer

Original Article

Journal of Breast Cancer

Journal of Breast Cancer 2006; 9(4): 317-322.

Published online: 31 December 2006

DOI: https://doi.org/10.4048/jbc.2006.9.4.317

Clinicopathologic factor and Lymphovascular Invasion in Breast cancer

Ja Seong Bae, Byung Joo Song, Mi la Kim, Seok Hyo Chang¹, Han Seong Kim², Woo Chan Park, Jeong Soo Kim, Sang Seol Jung

Department of Surgery, College of Medicine, The Catholic University of Korea, Korea.

¹Department of Surgery, College of Medicine, Inje University, Korea.

²Department of Pathology, College of Medicine, Inje University, Korea.

bjsong@catholic.ac.kr

Received 21 September 2006 Accepted 13 December 2006

Abstract

Purpose

Clinicopathologic factors associated with prognosis in breast cancer patients have varied. Among clinicopathologic factors, lymphovascular invasion (LVI) has been suggested to be a significant prognostic indicator for breast cancer. LVI means that cancer cells were found invading the lymphatics in the breast parenchyma adjacent to or well beyond the margin of the invasive tumor, and this can be an indicator of an increased chance that cancer could spread, as is demonstrated by the positive lymph nodes. The objective of this study was to determine whether LVI are associated with other clinicopathologic factors in breast cancer.

Methods

The expression of HER-2, Ki-67, P53, estrogen receptor and progesterone receptor was determined immunohistochemically in 120 breast cancer patients, including 77 patients that demonstrated the absent of LVI and 43 patients with the present of LVI.

Results

LVI was noted in 43 patients (35.8%) of the 120 breast cancer patients. Of the 77 patients with absent of LVI, the number of stage III patients (13 patients, 16.9%) was lower than the number of stage I (25 patients, 32.5%) and stage II breast cancer patients (39 patients, 50.6%). Of the 43 patients with absent of LVI, 5 patients (11.6%), 13 patients (30.2%), and 25 patients (58.2%) were in stage I, II, and III, respectively. There was a significant correlation between LVI and the stage (P=0.000). The strong expression (+3) of HER-2 was seen in 17 (39.5%) of the 43 patients in whom LVI was seen and in 15 (19.5%) of the 77 patients in whom LVI was not seen. Overexpression of Ki-67 was noted in 42 (97.7%) of the 43 patients in whom LVI was seen and in 64 (83.1%) of the 77 in whom LVI was not seen. HER-2 and Ki-67 overexpression was significantly associated with LVI (p=0.027 and p=0.018, respectively). LVI did not correlate with the expression of P53, the estrogen receptor status and the progesterone receptor status. There was a strong association of LVI and the lymph node status (p=0.000). Finally, LVI was associated with tumor size (p=0.014) and with the nuclear grade (p=0.022).

Conclusion

This study demonstrates the potential value of the lymph nodal status, tumor size, stage and nuclear grade for the assessment of lympho-vascular invasion; and the overexpressions of HER-2 and Ki-67 were strong indicators of LVI in invasive ductal carcinoma of the breast.

Keywords: Lymphovascular invasion, clinicopathologic factor, breast cancer

Figures and Tables

Fig 1

A cluster of carcinoma grands is found in peritumoral lymphatics (HE stain , ×200)

Fig 2

Tumor embolus in lymphatics is positively stained by HER-2 immunohistochemistry (×200)

Table 1

Clinicopathologic information of patients

Table 2

Characteristics of lymphovascular invasion and clinicopathologic parameters

EIC = Extensive intraductal component; LN = Lymph node.

Table 3

Characteristics of lymphovascular invasion and molecular biologic parameters

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