Tumor Size, Nuclear Grade and HER2 Positivity Predict Lymph Node Metastasis in Breast Carcinomas That Have Lymphovascular Invasion
X Xiao, J Wang, P Petry, T Albrecht, S Xu, DG Hicks, K Skinner, P Tang. University of Rochester Medical Center, Rochester, NY; RTI Health Solutions, Research Triangle Park, NC
Background: Lymphovascular invasion in breast carcinomas has been shown to be a poor prognostic factor, at least partly due to its frequent association with lymph node metastasis. In current study, we sought to investigate predictive clinicopathologic factors for lymph node metastasis in breast carcinomas that have lymphovascular invasion.
Design: Two hundred ninety-one cases of breast carcinomas with lymphovascular invasion between 1997 and 2008 were identified from our departmental file. Clinicopathological information including age of patients, tumor type, tumor size, histologic grade, nuclear grade, lymph node status, and expression of ER, PR and HER2 were recorded. Statistical analyses were performed to compare lymph node positive and negative tumors.
Results: Among the 291 cases, 106 cases (36.4%) had negative lymph nodes and 185 (63.6%) cases had positive lymph nodes. In node negative tumors, 99% and 1% were ductal and lobular carcinoma, respectively. In node positive tumors, 95% and 5% were in ductal and lobular carcinomas. Although there was a trend of lobular carcinoma being more frequently associated with nodal metastasis, no significant difference was seen between these two groups (p=0.2136). The mean ages were 57.43 for node negative tumors and 55.50 for node positive tumors (p=0.2181). There was a significant difference of tumor size between node negative (2.27cm) and node positive tumors (3.55cm), with a p-value less than 0.0001. While we did not observed a significant different for histologic grade between these two groups (p=0.4018); there was a significant difference for nuclear grade between these two groups (p=0.018). There was also difference in HER2 over-expression between these two groups (p=0.0595), but no difference was observed in the expression of ER (p=0.4379) and PR (p=0.6648) between these two groups of tumors.
Conclusions: Tumor size, nuclear grade, and HER2 positivity predict lymph node metastasis in breast carcinomas that have lymphovascular invasion. Tumor type, patient age, histologic grade, and expression of ER and PR are not predictive.
Wednesday, March 24, 2010 1:00 PM
Poster Session VI # 9, Wednesday Afternoon