The importance of vascular invasion (vi) in women with breast cancer (bc) and between 1 and 3 positive nodes: Analysis of 272 patients

Abstract

20062 Background: Node positivity and the number of positive nodes are the most important prognostic factors in BC, and affected patients usually have a worse OS. The presence of VI in primary BC is a prognostic factor correlated with a high risk of metastatic spread whose importance led to it being included in the new classification proposed at the VII St. Gallen Consensus Conference. Methods: We studied VI in 272 pts with invasive BC and 1–3 positive nodes in order to evaluate its importance, and correlate it with the pathological, biological and clinical factors of T (1,2,3,4), diameter (0–10 mm, 11–20 mm, 21–50 mm, ≥50 mm), grading (G1, G2, G3), ER and PgR (positive vs negative), Ki-67 proliferative index (low 0–10%; intermediate 11–25%; high 26–100%), c-erbB2 (positive vs negative), age at diagnosis (≤49, 50–65, ≥65 years), type of diagnosis (asymptomatic vs symptomatic) and type of surgery (conservative vs mastectomy). The data were analysed using the chi-squared test. Results: Unlike those without VI, the tumours with node involvement (N+ 1–3) and VI correlated with poor prognostic factors: they were larger (pT2: 62.5% vs 37.5%; p = 0.001), had higher grades (G2: 50.7% vs 49.3%; G3: 72.2% vs 27.8%; p = 0.0004), and were more likely to be ER- (75.6% vs 24.4%; p = 0.004) and c-erbB2+ (50.6% vs 49.4%; p = 0.06). The patients were younger at diagnosis (63% vs 37% aged ≤49 years; p = 0.01) and more likely to have a symptomatic diagnosis (61% vs 39%; p = 0.001). No association with PgR was found. Conclusion: Our results show that primary BC with N+ 1–3 and VI+ correlates with poorer prognostic factors (diameter >20 mm, G2/G3, ER-, c-erbB2+, younger age and symptomatic diagnosis). These correlations are in accordance with the new classification proposed at the VII St. Gallen Consensus Conference concerning high-risk pts with early BC. As these pts are at high risk of recurrence after good local surgery, it is important to offer them adequate adjuvant therapy as a reasonable treatment opinion on the basis of their endocrinal responsiveness. No significant financial relationships to disclose.