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Potential roles of lymphovascular space invasion based on tumor characteristics provide important prognostic information in T1 tumors with ER and HER2 positive breast cancer

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Abstract

Purpose

Patients presenting with lymphovascular space invasion (LVSI) had an absolute decrease in survival. In our present study, the potential roles of LVSI on tumor characteristics was explored to predict the difference in the prognosis of ER and HER2 positive T1 tumors.

Methods

A total of 142 breast cancer patients diagnosed with ER+ and HER2+ tumors whose tumor size was ≤ 2 cm were included in this analysis. One hundred forty-two patients were divided into four groups, group 1 (lymph nodes+ and LVSI+), group 2 (lymph nodes+ and LVSI−), group 3 (lymph nodes− and LVSI+), group 4 (lymph nodes− and LVSI−). Univariate and multivariate Cox proportional hazard models were used to identify independent prognostic factors and calculate the HR and 95% CI. Kaplan–Meier and Cox regression models were used to test the prognostic significance.

Results

LVSI positivity was significantly associated with patient age, menopausal status, tumor size, lymph node status, Ki67, PR, and tumor grade. In the univariate and multivariate model, LVSI, PR, and Ki67 were significantly associated with DFS, and LVSI, lymph node status, PR, and Ki67 were significantly associated with OS. LVSI was significantly related to increased risk of DFS and OS only in the PR-negative and low-positive subgroups. It was a prognostic factor for DFS but not for OS in women with low Ki67 and was associated with DFS and OS in high-Ki67 tumors. Furthermore, patients who presented with only LVSI had a significantly worse survival rate than those with lymph node metastasis without LVSI in small tumors.

Conclusion

The presence of LVSI was highlighted as a variable significant to survival. In further clinical practice, patients with LVSI may need more intensive treatment in certain populations.

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Acknowledgements

We would like to extend our sincere gratitude to our departmental chair for all their support. In addition, we would like to give many thanks to our physicians, engineers, and nurses as well as other staff of the department.

Funding

Heilongjiang Province of Science and Technology (Grant 201716), and the Harbin Science and Technology Bureau (Grant 2017RAXQJ067).

Author information

Author notes

  1. Y. Zhao and N. Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Breast Surgery, The Tumor Affiliated Hospital of Harbin Medical University, Harbin, China

    Y. Zhao & Y. Huang

  2. Department of Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

    N. Yang

  3. Department of In-Pantient Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    X. Wang & X. Zhou

  4. Department of Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, 150086, Heilongjiang, China

    D. Zhang

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  1. Y. Zhao
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  4. Y. Huang
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  6. D. Zhang
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Correspondence to D. Zhang.

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The authors report no conflicts of interest in this work.

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Ethical approval was provided by the Institutional Review Board of Harbin Medical University.

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Informed consent was obtained from all patients included in the study.

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Zhao, Y., Yang, N., Wang, X. et al. Potential roles of lymphovascular space invasion based on tumor characteristics provide important prognostic information in T1 tumors with ER and HER2 positive breast cancer. Clin Transl Oncol 22, 2275–2285 (2020). https://doi.org/10.1007/s12094-020-02369-9

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  • DOI: https://doi.org/10.1007/s12094-020-02369-9

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