An evaluation of lymphovascular invasion in relation to biology and prognosis according to subtypes in invasive breast cancer

Nishimura,Reiki; Osako,Tomofumi; Okumura,Yasuhiro; Nakano,Masahiro; Ohtsuka,Hiroko; Fujisue,Mamiko; Arima,Nobuyuki

doi:10.3892/ol.2022.13366

An evaluation of lymphovascular invasion in relation to biology and prognosis according to subtypes in invasive breast cancer

Authors:
- Reiki Nishimura
- Tomofumi Osako
- Yasuhiro Okumura
- Masahiro Nakano
- Hiroko Ohtsuka
- Mamiko Fujisue
- Nobuyuki Arima
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Affiliations: Department of Breast Oncology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan, Department of Pathology, Kumamoto Shinto General Hospital, Kumamoto, Kumamoto 862‑8655, Japan
Published online on: June 7, 2022 https://doi.org/10.3892/ol.2022.13366
Article Number: 245
Copyright: © Nishimura et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Lymphovascular invasion (LVI) is associated with a poor outcome in breast cancer. The purpose of the present study was to evaluate the clinical significance of LVI in primary breast cancer and to investigate disease‑free survival as a prognostic marker according to the breast cancer subtypes. This study examined 4,652 consecutive cases of invasive breast cancer excluding the patients with non‑invasive cancer, stage IV and those who underwent neo‑adjuvant therapy from February 2002 to February 2021. The clinicopathological characteristics and prognosis of LVI‑positive and ‑negative tumors were compared. LVI was evaluated in H&E staining specimens from surgically resected samples. The LVI expression rates were 29.2% (low, 19.7%; high, 9.5%) in all primary cases. The LVI‑positive rate was significantly associated with specimens with the following characteristics: ER/PgR‑negative, HER2‑positive, p53 overexpression, higher Ki‑67 index values, higher nuclear grade, positive nodes and larger tumors. Moreover, the subtypes were significantly associated with LVI positivity; 20% in Luminal A, 34.6% in Luminal B, 40.9% in Lumina/HER2, 38.1% in HER2‑enriched and 29.8% in triple negative (TN). There were significant differences in disease‑free survival between LVI status in Luminal A, Luminal B and TN subtypes, but there was no difference in the Luminal/HER2 and HER2‑enriched subtypes. A multivariate analysis revealed that LVI was a significant factor in Luminal B and TN subtypes. Overall, LVI was significantly associated with the advanced and aggressive characteristics in breast cancer. Luminal A type had a lower LVI rate, and HER2 type had a higher LVI rate. Moreover, LVI was a significant prognostic factor in Luminal B and TN subtypes. These data suggested that the LVI status was useful in predicting the prognosis in HER2 negative breast cancer cases.

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