Lymph node status combined with lymphovascular invasion creates a more powerful tool for predicting outcome in patients with invasive breast cancer

Background: Multiple clinical, biologic, and pathologic factors are known to correlate with outcome in patients with invasive breast cancer. The utility of lymphovascular invasion as an additional useful prognostic indicator has been heretofore ill defined. The purpose of the current study was to determine whether the presence or absence of peritumoral lymphovascular invasion (LVI) contribute further significant information in assessing survival. Methods: Using a prospective database of 1,258 patients with invasive breast cancer followed up for as long as 12 years, eight factors were evaluated for their impact on patient survival: lymph node status, LVI, age at diagnosis, tumor size, tumor palpability, estrogen and progesterone receptor status, and nuclear grade. Results Multivariate analysis revealed that both lymph node status and the presence or absence of LVI were highly significant independent predictors of outcome. Conclusions Knowledge of both lymph node status and the presence or absence of LVI can be used to predict which subset of patients will do extremely well (node negative + LVI absent) or extremely poorly (node positive + LVI present). The combination of the two factors is most meaningful in patients with 1 to 3 positive nodes.