Prognostic significance of blood vessel invasion in carcinoma of the breast in women

Sampat, M. B.; Sirsat, M. V.; Gangadharan, P

doi:10.1002/jso.2930090613

Cited by 52 publications

(19 citation statements)

References 5 publications

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“…The rate of BVI fell within the range of 4.2 -52.0% as observed in other studies (Teel and Sommers, 1964;Friedell et al, 1965;Sampat The combination of angiogenesis and blood vessel invasion T Kato et al et al, 1977;Cooperative Breast Cancer Group, 1978;Martin et al, 1987;Fisher et al, 1993;Kister et al, 1996;Lauria et al, 1996;Kato et al, 2002). In this study, BVI in the breast cancer patients we observed was seen in 148 cases (29.3%).…”

Section: Discussionsupporting

confidence: 81%

“…Therefore, there was a possibility of overlooking some kinds of blood vessel invasion using H&E staining alone. When Weigand et al (1982) and others (Sampat et al, 1977) examined the prognostic value of BVI, BVI correlated significantly with a high rate of recurrence. The results of our study suggest that BVI is an adverse prognostic factor among patients with breast cancer as well as lymph-node status.…”

Section: Discussionmentioning

confidence: 96%

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The combination of angiogenesis and blood vessel invasion as a prognostic indicator in primary breast cancer

et al. 2003

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This study was undertaken to examine the interaction between the combination of angiogenesis and blood vessel invasion (BVI) and haematogenous metastasis, and to determine the prognostic significance of that combination in predicting 20-year relapse-free survival (RFS) and overall survival (OS) rates in primary breast cancer. Five hundred and nine patients were studied. We investigated 11 factors, including average microvessel count (AMC)/BVI, lymph-node status (n), clinical tumour size (T), histological grade (HG), lymphatic vessel invasion (LVI), p53, proliferating cell nuclear antigen (PCNA), c-erbB-2, mitotic index (MI), apoptotic index, and tumour necrosis (TN). Blood vessel invasion was detected by both factor VIII-related antigen and elastica van Gieson staining. To evaluate the best objective method to quantify microvessel density in angiogenesis, AMC was employed. The rate of AMC-high and BVI-positive tumours was 32.6 and 29.3%, respectively. That of both AMC-high and BVI-positive tumours was 10.1%. Univariate analysis showed that AMC/BVI, n, T, HG, LVI, p53, PCNA, MI, and TN were significantly predictive of RFS and OS. By multivariate analysis, AMC/BVI was the strongest independent prognostic factor for 20-year RFS (relative risk (RR) ¼ 5.5; Po0.0001) and for 20-year OS (RR ¼ 4.3; Po0.0001). Lymph-node status was still considered a powerful prognostic indicator; however, the combination of AMC and BVI provided more reliable prognostic information than lymph-node status for haematogenous dissemination.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 96%

The combination of angiogenesis and blood vessel invasion as a prognostic indicator in primary breast cancer

et al. 2003

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“…The prognostic importance of these findings on local and distant recurrence has been described previously [11,37,38], and they were significant predictors of distant recurrence in our material when analyzed as single variables. In multivariate analysis the predictive value decreased, probably in part due to a significant correlation with other variables in the model, mainly lymph node status, tumor size, and multifocal growth.…”

Section: Recurrence In Relation To the Prognostic Variables In Patienmentioning

confidence: 72%

Cytometric and histopathologic features of tumors detected in a randomized mammography screening program: Correlation and relative prognostic influence

Hatschek

Gröntoft

Fagerberg

et al. 1990

Breast Cancer Res Tr

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Cytometric determination of S-phase fraction and ploidy type was performed on 430 tumors detected within a randomized trial of mammographic screening. The results were compared to several histopathologic features. A high S-phase fraction was estimated in tumors with a high grade of malignancy and other histopathologic findings related to rapid tumor progression, including lack of tubule formation, a high mitotic index, marked nuclear pleomorphism, multifocal cancer growth, tumor emboli in lymphatic and blood vessels, tumor necrosis, and inflammatory reaction. DNA aneuploidy was correlated with a high malignancy grade, frequent mitoses, a high degree of nuclear pleomorphism, vascular invasion, necrosis, and the presence of noninvasive ductal carcinoma. Both cytometric variables were inversely related to the degree of elastosis. Positive nodes, large tumor size, DNA aneuploidy, a high S-phase fraction, high grade of malignancy, lack of tubule formation, as well as high mitotic index and pleomorphism, presence of multifocal cancer, and vascular invasion, predicted a significantly shorter distant recurrence-free interval after a median follow-up time of 46.6 months. Elastosis and the presence of estrogen and progesterone receptors indicated favorable prognosis. In the multivariate analysis, only lymph node status, tumor size, S-phase fraction, and multifocal growth pattern had independent prognostic value.

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“…Therefore, tumour cell emboli in lymph and blood vessels are considered to be the morphological correlates of BC metastasising to loco-regional lymph nodes (LNs) and distant haematogenous sites, respectively. The presence of lymphovascular invasion indeed has been correlated to the presence of LN metastases and to poor prognosis in patients with BC (Sampat et al, 1977;Nealon et al, 1979Nealon et al, , 1981Dawson et al, 1982Dawson et al, , 1986Weigand et al, 1982;Bettelheim et al, 1984;Berger et al, 1988;Rosen et al, 1989Rosen et al, , 1991Lee et al, 1990;Clayton, 1991;Clemente et al, 1992;Neville et al, 1992;Fisher et al, 1993a, b;Lauria et al, 1995). Recently, interest in (lympho)vascular invasion has been increased owing to addition of peritumoural (lympho)vascular invasion to the St Gallen criteria for selection of adjuvant systemic treatment in operable BC (Goldhirsch et al, 2005).…”

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confidence: 99%

“…One of the major challenges has been to distinguish intratumoural lymph and blood vessels on HE slides from retraction artefacts caused by tissue fixation and processing. Most authors only included vessels with a clear-cut endothelium (Sampat et al, 1977;Nealon et al, 1979Nealon et al, , 1981Dawson et al, 1982Dawson et al, , 1986Weigand et al, 1982;Bettelheim et al, 1984;Berger et al, 1988;Rosen et al, 1989Rosen et al, , 1991Orbo et al, 1990;Clayton, 1991;Clemente et al, 1992;Neville et al, 1992;Fisher et al, 1993a, b;Pinder et al, 1994;Lauria et al, 1995), missing small and collapsed intratumoural vessels or vessels completely filled with tumour cells. Therefore, some authors only studied peritumoural LVI and BVI (Clemente et al, 1992;Neville et al, 1992;Lauria et al, 1995) or used morphological and topographical criteria to identify LVI (Orbo et al, 1990).…”

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confidence: 99%

Distinguishing blood and lymph vessel invasion in breast cancer: a prospective immunohistochemical study

et al. 2006

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Recently, peritumoural (lympho)vascular invasion, assessed on haematoxylin -eosin (HE)-stained slides, was added to the St Gallen criteria for adjuvant treatment of patients with operable breast cancer (BC). New lymphatic endothelium-specific markers, such as D2-40, make it possible to distinguish between blood (BVI) and lymph vessel invasion (LVI). The aim of this prospective study was to quantify and compare BVI and LVI in a consecutive series of patients with BC. Three consecutive sections of all formalin-fixed paraffinembedded tissue blocks of 95 BC resection specimens were (immuno)histochemically stained in a fixed order: HE, anti-CD34 (panendothelium) and anti-D2-40 (lymphatic endothelium) antibodies. All vessels with vascular invasion were marked and relocated on the corresponding slides. Vascular invasion was assigned LVI (CD34" or~/D2-40") or BVI (CD34"/D2-40~) and intra-(contact with tumour cells or desmoplastic stroma) or peritumoural. The number of vessels with LVI and BVI as well as the number of tumour cells per embolus were counted. Results were correlated with clinico-pathological variables. Sixty-six (69.5%) and 36 (37.9%) patients had, respectively, LVI and BVI. The presence of 'vascular' invasion was missed on HE in 20% (peritumourally) and 65% (intratumourally) of cases. Although LVI and BVI were associated intratumourally (P ¼ 0.02), only peritumoural LVI, and not BVI, was associated with the presence of lymph node (LN) metastases (p peri ¼ 0.002). In multivariate analysis, peritumoural LVI was the only independent determinant of LN metastases. Furthermore, the number of vessels with LVI was larger than the number of vessels with BVI (P ¼ 0.001) and lymphatic emboli were larger than blood vessel emboli (P ¼ 0.004). We demonstrate that it is possible to distinguish between BVI and LVI in BC specimens using specific lymphatic endothelium markers. This is important to study the contribution of both processes to BC metastasis. Furthermore, immunohistochemical detection of lymphovascular invasion might be of value in clinical practice.

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Prognostic significance of blood vessel invasion in carcinoma of the breast in women

Cited by 52 publications

References 5 publications

The combination of angiogenesis and blood vessel invasion as a prognostic indicator in primary breast cancer

The combination of angiogenesis and blood vessel invasion as a prognostic indicator in primary breast cancer

Cytometric and histopathologic features of tumors detected in a randomized mammography screening program: Correlation and relative prognostic influence

Distinguishing blood and lymph vessel invasion in breast cancer: a prospective immunohistochemical study

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