275P - Immunohistochemical ascertainment improves the prognostic value of lymphatic and blood vessel invasion in primary ductal breast cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Pathology/Molecular Biology
Breast Cancer
Basic Scientific Principles
Presenter Fadia Gujam
Citation Annals of Oncology (2014) 25 (suppl_4): iv85-iv109. 10.1093/annonc/mdu327
Authors F.J. Gujam1, J.J. Going2, Z.M. Mohammed2, C. Orange3, J. Edwards4, D.C. McMillan1
  • 1Academic Unit Of Surgery, University of Glasgow, G4 OSF - Glasgow/GB
  • 2Academic Unit Of Surgery, University of Glasgow, G4 - SF/GB
  • 3Pathology, University of Glasgow, G51 - TF/GB
  • 4Institute Of Cancer Sciences, University of Glasgow, G4 - SF/GB

Abstract

Aim

Lymphovascular invasion (LBVI) including lymphatic (LV) and blood (BVI) vessel invasion is a critical step in cancer metastasis. In breast cancer, the optimal detection method of LBVI remains unclear. This research aimed to compare the prognostic value of different assessment of the LVI and BVI in patients with early breast cancer.

Methods

The study cohort included 360 patients with a median follow-up of 168 months. LBVI on H&E sections (LBVIH&E) was identfied fom reviewing H&E slides. Immunohistohemical stining for D2-40 and Factor VIII was performed to identify LVID2-40 and BVIFVIII.

Results

LBVIH&E, LVID2-40 and BVIFVIII were present in 102(28%), 127(35%) and 59(16%) patients respectively. In node negative patinets (206), LBVIH&E, LVID2-40 and BVIFVIII were present in 41(20%), 53(26%) and 21(10%) respectively. In tripe negative patients (150), LBVIH&E, LVID2-40 and BVIFVIII were present in 47(31%), 61(41%) and 21(14%) respectively. LBVIH&E was significantly associated with tumour recurrence in the whole cohort (P < 0.001), node negative patients (P = 0.001) and triple negative patients (P = 0.001). LVID2-40 and BVIFVIII were significantly associated with tumour recurrence in the whole cohort, node-negative and triple negative patients (all P < 0.001). In multivariate analysis, only LVID2-40 and BVIFVIII were independent predictors of cancer specific survival in the whole cohort (P = 0.001 and P < 0.001 respectively), node negative patients (P = 0.004 and P = 0.001 respectively) and triple negative patients (P = 0.010 and P = 0.008 respectively).

Conclusions

Assessment of LVI and BVI by IHC using D2-40 and Factor VIII improves prediction of outcome in patients with node negative and triple negative breast cancer. These results make a case for routine clinical assessment of lymphatic and blood vessel invasion by IHC to ascertain LVI and BVI.

Disclosure

All authors have declared no conflicts of interest.