Predictors of lymphovascular invasion in estrogen receptor positive/Her-2 negative breast cancer patients treated with neoadjuvant chemotherapy.

Abstract

Lymphovascular invasion (LVI) is considered a high-risk factor for recurrence in early-stage breast cancer, hence examination of LVI in pathological samples is an absolute recommendation. We aim to investigate predictive factors of LVI in preneoadjuvant chemotherapy (NAC) patients with estrogen receptor positive (ER+) and human epidermal growth factor receptor 2 negative (HER2-) molecular subtypes of breast cancer. One hundred and thirty-four patients treated with NAC were included in this study who were ER+/HER2-. The clinical characteristics of the patients, the data obtained from the core needle biopsy before NAC and the LVI status in the pathology that examined after breast surgery were collected. Univariate and multivariate analysis were performed using the logistic regression model. An examination of the association between LVI and clinical-pathological patient characteristics showed that advanced age (>40 years old) (p = 0.021), ductal histology (p = 0.039), and presence of axillary lymph node metastasis (p = 0.005) were predictors of LVI. Independent predictors of LVI in a multivariate logistic model included advanced age (p = 0.037), and the presence of axillary lymph node metastasis prior to NAC (p = 0.006). The median RFS (Recurrence-free survival) time was 22.8 months for all patients. RFS was shorter in patients with LVI (log-rank p = 0.037). Independent predictors of LVI are advanced age and lymph node positivity at the time of diagnosis. Our study is the first study that evaluates pre-NAC predictive factors of LVI in ER+/HER2- breast cancer patients treated with NAC.