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Lymphovascular invasion is an independent predictor of survival in breast cancer after neoadjuvant chemotherapy

  • Epidemiology
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Abstract

Various prognostic indicators have been investigated in neoadjuvant chemotherapy (NAC)-treated invasive breast cancer (BC). Our study examines if lymphovascular invasion (LVI) is an independent predictor of survival in women receiving NAC. We performed a retrospective analysis in 166 women with operable invasive BC who underwent adriamycin- and taxane-based NAC between 2000 and 2013. The presence of LVI was noted in breast excisions following NAC. Associations between progression-free and overall survival and LVI and other clinicopathologic variables were assessed. Median follow-up was 31 months (range 1.4–153 months) with a total of 56 events and 24 deaths from any cause. LVI was found in 74 of 166 patients (45 %). In univariate analysis, the presence of LVI was associated with worse progression-free survival (HR 3.37, 95 % CI 1.87–6.06, p < 0.01) and overall survival (HR 4.35, 95 % CI 1.61–11.79, p < 0.01). In multivariate models adjusting for breast cancer subtype, LVI was significantly associated with a decrease in progression-free survival (HR 3.76, 95 % CI 2.07–6.83, p < 0.01) and overall survival (HR 5.70, 95 % CI 2.08–15.64, p < 0.01). When stratified by subtype, those with hormone receptor or HER2-positive BCs with no LVI had the most favorable progression-free and overall survival. Those with both LVI and triple-negative BC had the worst progression-free and overall survival. LVI is an important prognostic marker and is associated with worse clinical outcome in breast cancer patients receiving NAC.

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Abbreviations

LVI:

Lymphovascular invasion

NAC:

Neoadjuvant chemotherapy

TNBC:

Triple-negative breast cancer

pCR:

Pathological complete response

PFS:

Progression-free survival

OS:

Overall survival

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Acknowledgments

This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant Number KL2 TR000081. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Medicine, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA

    Ying L. Liu

  2. Department of Radiation Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA

    Anurag Saraf & Eileen P. Connolly

  3. Department of Biostatistics, Columbia University School of Medicine, New York, NY, USA

    Shing M. Lee & Xiaobo Zhong

  4. Department of Pathology and Cell Biology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA

    Hanina Hibshoosh

  5. Department of Medical Oncology, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA

    Kevin Kalinsky

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  1. Ying L. Liu
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  2. Anurag Saraf
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Correspondence to Eileen P. Connolly.

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Ying L. Liu and Anurag Saraf—co authors.

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Liu, Y.L., Saraf, A., Lee, S.M. et al. Lymphovascular invasion is an independent predictor of survival in breast cancer after neoadjuvant chemotherapy. Breast Cancer Res Treat 157, 555–564 (2016). https://doi.org/10.1007/s10549-016-3837-5

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