Table 1.
Association of lymphatic vessel invasion (LVI) with lymphatic metastasis in breast cancer
# of Patients |
Method of Analysis |
Comments | P valuea | Reference |
---|---|---|---|---|
4,351 | H&Eb | Sentinel LNb metastasis was strongly associated with peritumoral vascular invasion (pVI) |
P<0.0001 | [37] |
2,606 | H&E | LN metastasis significantly correlated with perivascular invasion encompassing both LVIb or BVIb |
P<0.0001 | [110] |
850 | H&E | LVI detected in 51% of patients was the most significant predictor for axillary LN metastases |
P<0.001 | [51] |
400 | IHCb | Patients with LVI were more likely to have sLNb metastases (51.3% of LVI-positive patients had positive sLN) |
P<0.001 | [46] |
374 | IHC | LVI was significantly associated with a higher risk for developing lymph node metastasis |
P=0.004 | [50] |
254 | H&E and IHC |
In a multivariate analysis, LVI was the strongest predictor for ALNMb with an odds ratio of 3.489 |
P=0.0003 | [41] |
206 | H&E | LVI was significantly associated with non-sentinel LN involvement (41% of LVI-positive patients had also positive LN versus 26% of LVI-negative patients) |
P=0.021 | [230] |
194 | H&E and IHC |
Strong association was found between pLVI and non-sentinel LN metastasis (65% versus 37%) |
P=0.001 | [231] |
177 | IHC | LVI was strongly associated with LN metastasis, distant metastasis, decreased disease-free interval and overall survival |
P<0.001 | [36] |
165 | H&E | LVI in the primary tumor was the only factor significantly associated with metastases in the non-sentinel LN |
P<0.01 | [45] |
123 | IHC | LVI but not BVI significantly correlated with lymphatic metastasis |
P=0.002 | [42] |
118 | H&E | LVI was a strong predictor of axillary LN metastasis regardless of tumor size |
P<0.0001 | [232] |
113 | IHC | LVI correlated with LN metastasis, LVDb and VEGF-Cb | P< 0.0001 | [70] |
98 | IHC | LVI correlated with VEGF-C, which was expressed in ~40% of breast cancers but not in adjacent normal mammary glands |
P=0.0004 | [67] |
95 | H&E and IHC |
Only peritumoral LVI, but not BVI, was associated with LN metastases. LVI exceeded BVI in both the number of invaded vessels and the size of the emboli. (P=0.004) |
P=0.002 | [44] |
P value indicates association of intratumoral or peritumoral lymphatic vessel invasion with LN metastasis.
Abbreviations: H&E, hematoxylin & eosin; LN, lymph node; LVI, lymphatic vascular invasion; BVI, blood vascular invasion; IHC, immunohistochemistry; sLN, sentinel lymph node; pLVI, peritumoral lymphatic vascular invasion; DFS, disease-free survival; OS, overall survival; ALNM, axillary lymph node metastasis; LEC, lymphatic endothelial cells; LVD, lymphatic vessel density; VEGF-C, vascular endothelial growth factor C.