Lymphatic and Vascular Invasion LVI

A study involving 1,704 women with early stage breast cancer revealed vascular invasion (lymphatic and/or blood vessel) on routine hematoxylin and eosin sections in the tumors of 23% of the examined patients; and its presence was associated with both decreased survival and increased local recurrence (28). Similarly, the recurrence rate in 644 women with stage I breast cancer was found to be significantly higher (38% compared to 22%) in those with vascular invasion than those without (29). A recent small study suggested that immunohistochemical detection of blood vessel invasion (BVI) with anti-CD34 (pan-endothelium) and lympho-vascular invasion with anti-D2-40 (lymphatic endothelium) antibodies found in peritumoral tissue were independent determinants of lymph node metastases (30).

Tumor histology and grade as well as lymphovascular invasion may be used for therapeutic consideration if the tumor size and the lymph node involvement leave the treatment decision ambiguous.

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