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Lymphovascular Invasion as a Predictive Factor for Recurrence in Triple-Negative Breast Cancer

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Abstract

Triple-negative breast cancer (TNBC) is relatively more aggressive than other subtypes of breast cancer. Lymphovascular invasion (LVI) is a well-known predictive factor of worse survival outcomes; however, the role of LVI in TNBC remains unclear. This study aimed to evaluate the significance of LVI and examine clinical outcomes in patients with TNBC. We reviewed the medical records of 417 patients with pathology results negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor type 2 (immunohistochemical stain score 0, 1, or 2 with negative for fluorescence (or silver) in situ hybridization). Cox proportional hazards analysis was used to investigate the relationship between clinicopathological variables and survival outcomes. During a median follow-up of 93.8 months (range, 7.1−193.8), 65 (15.6%) patients had recurrence, and 37 (8.9%) patients died from cancer progression. In multivariate analyses of survival outcomes, the N1–3 stage (vs. N0 stage; hazard ratio [HR], 2.127; 95% confidence interval [CI], 1.237−3.659; p = 0.006), and LVI (vs. no LVI; HR, 2.053; 95% CI, 1.199−3.515; p = 0.009) were associated with worse recurrence-free survival. The N1–3 stage (vs. N0 stage; HR, 4.386; 95% CI, 2.140−8.988; p < 0.001) was associated with worse disease-specific survival. LVI in TNBC is an important predictive factor for recurrence than cancer-related death after adjustment for other prognostic factors. We suggest that patients with TNBC with LVI should receive short-term follow-up with imaging studies for detecting loco-regional and distant recurrence.

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Abbreviations

BCS:

breast-conserving surgery

BMI:

body mass index

CI:

confidence interval

DSS:

disease-specific survival

ER:

estrogen receptor

FISH:

fluorescence in situ hybridization

FNAC:

fine-needle aspiration cytology

HER2:

human epidermal growth factor receptor type 2

HR:

hazard ratio

IHC:

immunohistochemistry

LVI:

lymphovascular invasion

PET-CT:

positron emission tomography-computed tomography

PR:

progesterone receptor

RFS:

recurrence-free survival

SISH:

silver in situ hybridization

TNBC:

triple-negative breast cancer

US:

ultrasonography

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Funding

This study was supported by a grant (HCRI 17914-1) from the Chonnam National University Hospital Biomedical Research Institute.

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Authors and Affiliations

  1. Department of Surgery, Chonnam National University Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, South Korea

    Yong Min Na, Young Jae Ryu, Jin Seong Cho, Min Ho Park & Jung Han Yoon

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  1. Yong Min Na
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Contributions

All authors contributed to the study conception and design. Formal analysis and investigation: Yong Min Na, Young Jae Ryu, Jin Seong Cho, and Min Ho Park. Writing—original draft preparation: Yong Min Na. Writing—review and editing: Young Jae Ryu. Funding acquisition: Young Jae Ryu. All authors read and approved the final manuscript.

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Correspondence to Young Jae Ryu.

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This study was approved by the institutional review board in Chonnam National University Hwasun Hospital, with the reference number CNUHH−2018−152.

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Na, Y.M., Ryu, Y.J., Cho, J.S. et al. Lymphovascular Invasion as a Predictive Factor for Recurrence in Triple-Negative Breast Cancer. Indian J Surg 83 (Suppl 2), 475–483 (2021). https://doi.org/10.1007/s12262-021-02783-5

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