Cargando…
Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up
BACKGROUND: Breast cancer related lymphoedema (BCRL) occurs in a substantial proportion of breast cancer survivors and is a major contributor to patients’ disability. Regrettably, there are no validated predictive biomarkers, diagnostic tools, and strong evidence-supported therapeutic strategies for...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162920/ https://www.ncbi.nlm.nih.gov/pubmed/30268112 http://dx.doi.org/10.1186/s12885-018-4851-2 |
_version_ | 1783359252627193856 |
---|---|
author | Invernizzi, Marco Corti, Chiara Lopez, Gianluca Michelotti, Anna Despini, Luca Gambini, Donatella Lorenzini, Daniele Guerini-Rocco, Elena Maggi, Stefania Noale, Marianna Fusco, Nicola |
author_facet | Invernizzi, Marco Corti, Chiara Lopez, Gianluca Michelotti, Anna Despini, Luca Gambini, Donatella Lorenzini, Daniele Guerini-Rocco, Elena Maggi, Stefania Noale, Marianna Fusco, Nicola |
author_sort | Invernizzi, Marco |
collection | PubMed |
description | BACKGROUND: Breast cancer related lymphoedema (BCRL) occurs in a substantial proportion of breast cancer survivors and is a major contributor to patients’ disability. Regrettably, there are no validated predictive biomarkers, diagnostic tools, and strong evidence-supported therapeutic strategies for BCRL. Here, we provide an integrative characterization of a large series of women with node-positive breast cancers and identify new bona fide predictors of BCRL occurrence. METHODS: Three hundred thirty-two cases of surgically-treated node-positive breast cancers were retrospectively collected (2–10.2 years of follow-up). Among them, 62 patients developed BCRL. To identify demographic and clinicopathologic features related to BCRL, Fisher’s exact test or Chi-squared test were carried out for categorical variables; the Wilcoxon rank-sum was employed for continuous variables. Factors associated with BCRL occurrence were assessed using a Cox proportional hazards regression model. RESULTS: En-bloc dissection of the axillary lymph nodes but not the type of breast surgery impacted on BCRL development. Most of BCRL patients had a Luminal A-like neoplasm. The median number of lymph nodes involved by metastatic deposits was significantly higher in BCRL compared to the control group (p = 0.04). Both peritumoral lymphovascular invasion (LVI) and extranodal extension (ENE) of the metastasis had a negative impact on BCRL-free survival (p = 0.01). Specifically, patients with LVI and left side localization harboured 4-fold higher risk of developing BCRL, while right axillary nodes metastases with ENE increased the probability of BCRL compared to ENE-negative patients. CONCLUSIONS: Assessment of LVI and ENE should be integrated with clinical and surgical data to improve BCRL risk stratification. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-018-4851-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6162920 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61629202018-10-04 Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up Invernizzi, Marco Corti, Chiara Lopez, Gianluca Michelotti, Anna Despini, Luca Gambini, Donatella Lorenzini, Daniele Guerini-Rocco, Elena Maggi, Stefania Noale, Marianna Fusco, Nicola BMC Cancer Research Article BACKGROUND: Breast cancer related lymphoedema (BCRL) occurs in a substantial proportion of breast cancer survivors and is a major contributor to patients’ disability. Regrettably, there are no validated predictive biomarkers, diagnostic tools, and strong evidence-supported therapeutic strategies for BCRL. Here, we provide an integrative characterization of a large series of women with node-positive breast cancers and identify new bona fide predictors of BCRL occurrence. METHODS: Three hundred thirty-two cases of surgically-treated node-positive breast cancers were retrospectively collected (2–10.2 years of follow-up). Among them, 62 patients developed BCRL. To identify demographic and clinicopathologic features related to BCRL, Fisher’s exact test or Chi-squared test were carried out for categorical variables; the Wilcoxon rank-sum was employed for continuous variables. Factors associated with BCRL occurrence were assessed using a Cox proportional hazards regression model. RESULTS: En-bloc dissection of the axillary lymph nodes but not the type of breast surgery impacted on BCRL development. Most of BCRL patients had a Luminal A-like neoplasm. The median number of lymph nodes involved by metastatic deposits was significantly higher in BCRL compared to the control group (p = 0.04). Both peritumoral lymphovascular invasion (LVI) and extranodal extension (ENE) of the metastasis had a negative impact on BCRL-free survival (p = 0.01). Specifically, patients with LVI and left side localization harboured 4-fold higher risk of developing BCRL, while right axillary nodes metastases with ENE increased the probability of BCRL compared to ENE-negative patients. CONCLUSIONS: Assessment of LVI and ENE should be integrated with clinical and surgical data to improve BCRL risk stratification. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-018-4851-2) contains supplementary material, which is available to authorized users. BioMed Central 2018-09-29 /pmc/articles/PMC6162920/ /pubmed/30268112 http://dx.doi.org/10.1186/s12885-018-4851-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Invernizzi, Marco Corti, Chiara Lopez, Gianluca Michelotti, Anna Despini, Luca Gambini, Donatella Lorenzini, Daniele Guerini-Rocco, Elena Maggi, Stefania Noale, Marianna Fusco, Nicola Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
title | Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
title_full | Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
title_fullStr | Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
title_full_unstemmed | Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
title_short | Lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
title_sort | lymphovascular invasion and extranodal tumour extension are risk indicators of breast cancer related lymphoedema: an observational retrospective study with long-term follow-up |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162920/ https://www.ncbi.nlm.nih.gov/pubmed/30268112 http://dx.doi.org/10.1186/s12885-018-4851-2 |
work_keys_str_mv | AT invernizzimarco lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT cortichiara lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT lopezgianluca lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT michelottianna lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT despiniluca lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT gambinidonatella lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT lorenzinidaniele lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT gueriniroccoelena lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT maggistefania lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT noalemarianna lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup AT fusconicola lymphovascularinvasionandextranodaltumourextensionareriskindicatorsofbreastcancerrelatedlymphoedemaanobservationalretrospectivestudywithlongtermfollowup |