272. Prognostic Implication of Lymphovascular Invasion in Triple Negative Early Breast Cancer

• DOI: 10.1016/j.ejso.2012.06.273
• Publication Date: 2012-09-19T14:16:40Z
• Authors: O. Saleem; R. Idress; G. Sheikh; L. Vohra; N. Kayani; S. Khan
• Keywords: Triple-negative breast cancer; Lymphovascular invasion; Negativity effect; Triple negative

Background: Choice of treatment for the recurrent breast cancer patients is generally decided according to the immunophenotype of the primary tumor. However, the hormonal status such as estrogen receptor (ER) and progesterone receptor (PR) is often altered in the metastatic site compared to that of the primary, leading to the inappropriate therapy. Patients and Methods: The ER and PR status of the breast cancer patients who relapsed during 1999 to 2011 were retrospectively compared between the primary and the recurrent. The presentation of ER and PR was assessed with immunohistochemical staining employing avidin-biotin method. Samples with 10% or more immunopositive malignant cells were classified as ER or PR positive. Results: A total of 55 patients were enrolled in this study. Pathological diagnoses of the primary cancers included 45 invasive ducal carcinomas, 2 invasive lobular carcinomas, 2 invasive micropapillary carcinomas, 1 medullary carcinoma, 1 ductal carcinoma in situ and the 3 others. For ER, conversion from positive to negative or negative to positive occurred in 13.5% (5 cases in 37 ER-positive) and 38.8% (7 cases in 18 ER-negative), respectively. For PR, 37.5% (12 cases) of the 32-positive changed into the negative, and 37.5% (9 cases) of the 21-negative changed into the positive. The organs from which the recurrent tumor samples were biopsied, included 17 lymph nodes, 16 pulmonary systems, 8 mammary glands, 5 livers, 3 gastrointestines, 2 cerebellums and 1 bone. The overall survival time of the patients whose primary tumors showed ER-positive was 7.29 +/4.19 (SD) years for those with the ER-negative relapse and 8.48 +/4.74 years for the ER-positive relapse, (log rank, p1⁄40.01). For the ER-positive relapse, no significant difference of the overall survival was recognized, independent of the primary ER status. Also for the ER-negative relapse, the primary ER status had no impact for the survival time. Talking about the PR status, almost the same tendency in survival was demonstrated. Conclusions: For the metastatic breast cancer patients, conversion of hormone receptor at the recurrent sites is found in nearly one third of the total. As hormonal positive relapse have favorable impact for survival, assessment of the tumor phenotype at the metastatic sites is required if possible. Including other morphological evaluation such as Ki67 and HER2, biological features of the metastatic breast cancer will be discussed at presentation.