The Role of Lymphangiogenesis in Regional Lymph Node Metastasis: Animal Models

Nathanson, S. David; Miller, Claudia; Paxton, James H.

doi:10.1007/978-1-60327-087-8_19

From Local Invasion to Metastatic Cancer 2009

DOI: 10.1007/978-1-60327-087-8_19

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The Role of Lymphangiogenesis in Regional Lymph Node Metastasis: Animal Models

S. David Nathanson

Claudia Miller

James H. Paxton

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2020

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“… 4 Lymphangiogenesis, the growth of new lymphatic capillaries in and around BCs, has since been demonstrated to be just as clearly a part of the progression of the disease as angiogenesis. 5 Two large pathologic studies, using specific lymphatic endothelial markers, have clearly shown that LVI in BC is primarily into lymphatics and not blood vessel capillaries, supporting the Halsted and disputing the Fisher hypothesis. 6 , 7 Furthermore, the progression of BC through the sentinel lymph node (SLN) before systemic spread was recently proven in mouse experiments.…”

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confidence: 96%

Clinicopathological Evaluation of the Potential Anatomic Pathways of Systemic Metastasis from Primary Breast Cancer Suggests an Orderly Spread Through the Regional Lymph Nodes

et al. 2020

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Background Two conflicting hypotheses as to how breast cancer (BC) accesses the systemic circulation dominated the 20th century and affected surgical treatment. We hypothesized that tumor lymphovascular invasion (LVI) at the primary tumor site favors lymphatic and not blood vessel, capillaries, and systemic metastases (Smets) are dependent upon regional lymph node (RLN) mets. Methods Data from BC patients undergoing RLN biopsy was professionally abstracted and maintained in a prospective, precisely managed, single-institution database. Associations of RLN, LVI, and Smets were estimated by univariate and multivariate backward logistic regression models and patient-affiliated demographic, clinicopathologic, treatment type, and molecular marker data. Results Of 3329 patients, followed 1–22 years (mean 7.8), 463 of 3329 (13.9%) showed LVI, 742 of 3329 (22.3%) had RLN mets, and 262 of 3329 (7.9%) had Smets. Smets occurred in 52 of 252 (21% with LVI+/RLN+); 116 of 2301 (5% with LVI−/RLN−); 65 of 465 (14% with LVI−/RLN+); and 17 of 207 (8% with LVI+/RLN−), p = 0.021 for association between LVI and Smets for RLN+ patients but not for RLN− patients ( p = 0.051). Positive RLN, larger tumor size, and higher grade (all p < 0.001) were predictive of Smets by the multivariable model, whereas positive LVI was not. Conclusions LVI predicts RLN mets in BC. RLN is critical to Smets from BC, whereas LVI on its own is not. Smets occur significantly more commonly when both LVI and RLN mets occur together. LVI is, thus, likely to be primarily lymphatic invasion, and rarely, blood vessel invasion, supporting the Halsted paradigm. LVI and RLN together predict clinical outcome better than either alone. Graphic Abstract

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confidence: 96%

Clinicopathological Evaluation of the Potential Anatomic Pathways of Systemic Metastasis from Primary Breast Cancer Suggests an Orderly Spread Through the Regional Lymph Nodes

et al. 2020

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The Role of Lymphangiogenesis in Regional Lymph Node Metastasis: Animal Models

Cited by 1 publication

References 92 publications

Clinicopathological Evaluation of the Potential Anatomic Pathways of Systemic Metastasis from Primary Breast Cancer Suggests an Orderly Spread Through the Regional Lymph Nodes

Clinicopathological Evaluation of the Potential Anatomic Pathways of Systemic Metastasis from Primary Breast Cancer Suggests an Orderly Spread Through the Regional Lymph Nodes

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