1. Lymphatic space invasion is not an independent predictor of outcomes in early stage breast cancer treated by breast-conserving surgery and radiation.
- Author
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Freedman GM, Li T, Polli LV, Anderson PR, Bleicher RJ, Sigurdson E, Swaby R, Dushkin H, Patchefsky A, and Goldstein L
- Subjects
- Antineoplastic Agents therapeutic use, Breast Neoplasms drug therapy, Breast Neoplasms mortality, Carcinoma, Ductal, Breast drug therapy, Carcinoma, Ductal, Breast mortality, Carcinoma, Ductal, Breast pathology, Carcinoma, Ductal, Breast radiotherapy, Carcinoma, Ductal, Breast surgery, Female, Follow-Up Studies, Humans, Mastectomy, Segmental, Middle Aged, Multivariate Analysis, Prognosis, Survival Rate, Treatment Outcome, Breast Neoplasms pathology, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Lymphatic Metastasis
- Abstract
To study the prognostic importance of lymphovascular invasion (LVI) in early stage breast cancer after conservative surgery and radiation. From 2/80 to 8/07, 1,478 patients were treated with breast-conserving surgery and radiation with or without systemic therapy. Study eligibility included breast conservation, whole breast postoperative radiation, T1-T2 disease, and known LVI status. Endpoints were 5- and 10-year actuarial outcomes for local control and survival. LVI was present in 427 patients and absent in 1,051 patients. Median follow-up was 68 and 69 months, respectively. Patients with LVI had a younger median age, were more often pre- or perimenopausal, T2, physically palpable, invasive ductal, node positive, grade 3, and treated with chemotherapy compared with patients without LVI. The 5- and 10-year local-regional recurrence was 4.5% and 9.6% with LVI compared with 1.6% and 5.6% without LVI (p = 0.01). The 5- and 10-year overall survival was 83% and 68% for LVI and 91% and 80% for no LVI, respectively (p < 0.0001). Multivariate analysis showed that LVI was not an independent predictor of local-regional control (p = 0.0697) or survival (p = 0.1184). LVI in breast cancer is found in association with other worse prognostic factors for outcome, is associated with a modest increase in local-regional recurrence, but is not an independent predictor of local-regional recurrence or survival on multivariate analysis., (© 2012 Wiley Periodicals, Inc.)
- Published
- 2012
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