Lymphovascular invasion (LVI) after neoadjuvant chemotherapy (NAC) for breast cancer (BC)

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,[email protected], https://plus.google.com/communities/1... , ,https://plus.google.com/u/0/+Alexandr... ,    / @otolaryngologistorlent-med3259   ,    / @alexandrosg.sfakianakis4746   , https://twitter.com/g_orl?lang=el,   / alexandrossfakianakis  , Lymphovascular invasion after neoadjuvant chemotherapy is strongly associated with poor prognosis in breast carcinoma. Breast Cancer Res Treat. 2018 Jan 27;: Authors: Hamy AS, Lam GT, Laas E, Darrigues L, Balezeau T, Guerin J, Livartowski A, Sadacca B, Pierga JY, Vincent-Salomon A, Coussy F, Becette V, Bonsang-Kitzis H, Rouzier R, Feron JG, Benchimol G, Laé M, Reyal F Abstract PURPOSE: Few studies evaluated the prognostic value of the presence of lymphovascular invasion (LVI) after neoadjuvant chemotherapy (NAC) for breast cancer (BC). METHODS: The association between LVI and survival was evaluated in a cohort of BC patients treated by NAC between 2002 and 2011. Five post-NAC prognostic scores (ypAJCC, RCB, CPS, CPS + EG and Neo-Bioscore) were evaluated and compared with or without the addition of LVI. RESULTS: Out of 1033 tumors, LVI was present on surgical specimens in 29.2% and absent in 70.8% of the cases. Post-NAC LVI was associated with impaired disease-free survival (DFS) (HR 2.54; 95% CI 1.96-3.31; P 0.001), and the magnitude of this effect depended on BC subtype (Pinteraction = 0.003), (luminal BC: HR 1.83; P = 0.003; triple negative BC: HR 3.73; P 0.001; HER2-positive BC: HR 6.21; P 0.001). Post-NAC LVI was an independent predictor of local relapse, distant metastasis, and overall survival; and increased the accuracy of all five post-NAC prognostic scoring systems. CONCLUSIONS: Post-NAC LVI is a strong independent prognostic factor that: (i) should be systematically reported in pathology reports; (ii) should be used as stratification factor after NAC to propose inclusion in second-line trials or adjuvant treatment; (iii) should be included in post-NAC scoring systems. PMID: 29374852 - video upload powered by https://www.TunesToTube.com