The influences of peritumoral lymphatic invasion and vascular invasion on the survival and recurrence according to the molecular subtypes of breast cancer.

Abstract

We aimed to compare the influences of lymphatic invasion (LI) and vascular invasion (VI) on survival and recurrence according to the molecular subtypes of breast cancer. We retrospectively analyzed data on 820 breast cancer patients and assessed overall survival (OS) and disease-free survival (DFS) according to LI and VI using the Kaplan-Meier estimator and the Cox proportional hazards model. Both positive LI and positive VI showed inferior OS and DFS compared with negative LI and negative VI (all p<0.001). Both positive LI and positive VI showed higher local, regional, and distant recurrence rates (p=0.002 for regional recurrence of VI, p<0.001 for all the others). Although LI was a significant independent predictor of OS (hazard ratio [HR] 1.927; 95% confidence interval [CI] 1.046-3.553) and DFS (HR 1.815; 95% CI 1.063-3.096), VI was not in the multivariate analyses. Regarding OS, both positive LI and positive VI showed worse survival rates in the luminal A (p=0.016 and p=0.024, respectively) and triple negative subtypes (both p<0.001). Regarding DFS, LI was a significant prognosticator in the luminal A and triple negative (both p<0.001) subtypes. VI was a significant prognosticator across all molecular subtypes, although the prognostic impact was most prominent in the luminal A subtype (p<0.001). Both LI and VI were significant, unfavorable prognostic factors of OS and DFS, especially in the luminal A and triple negative breast cancer subtypes. Although LI was a significant independent predictor of OS and DFS, VI was not after the multivariate analyses.