Relationship between lymphovascular invasion (LVI) and prognostic markers in different subtypes of breast cancer

Abstract

e22109 Background: Prognostic and predictive factors for invasive breast cancer (BC) are well established. LVI was added to the list of prognostic factors for node negative patients (St.Gallen 2006). The aim of this study was to investigate the relationship of LVI with known prognostic markers and its role on different subtypes of breast cancer. Methods: 367 patients with primary BC were evaluated in this study. Tumoral and peritumoral breast tissue was examined for LVI. The patient's age, menopausal status, tumor histology, tumor size, histologic grade, lymph node (LN) involvement, hormone receptor (HR) status and HER-2 status were determined as markers of prognosis. The association of LVI with the aforementioned markers was evaluated using multiple logistic regression analysis. Results: The distribution of the patients was as follows: 40.9% were HR + and HER-2 - (luminal type), (32.4%) were triple negative, 26.7% were HER-2 Positive (9.5% of them were HER-2 + and HR -, while 17.2% were HER-2 + and HR+). Almost half of the patients (48.8%) had one or more positive nodes. Multiple analysis revealed that histologic grade, LN involvement and HER-2 positivity were independently associated with LVI. Patients with histologic grade II and III had 5.31 (95% CI: 1.14–24.75) and 7.03 (95% CI: 1.47- 33.53) times greater odds for LVI respectively compared to those with grade I. Patients with one or more than three nodes involved had 3.95 (95% CI: 2.13–7.33) and 6.29 (95% CI: 3.14–12.63) times greater odds for LVI respectively compared with node negative tumors. Furthermore, HER-2 positive patients had almost twofold likelihood for LVI (OR=1.80, 95% CI: 1.02–3.16). The effect of HER-2 positivity on LVI was independent of HR status. Age, menopausal status, tumor histology, tumor size and HR status were not significantly associated with LVI. Conclusions: LVI shows a close relationship with known markers of poor prognosis as histologic grade, and LN invasion. More aggressive tumors as HER-2 + tumors have a significantly higher probability of LVI, which may be used as an indicator of more aggressive behavior of the primary tumor. No significant financial relationships to disclose.