Correlation Between Lymphovascular Invasion And Clinicopathological Features And Prognosis In Patients With Invasive Breast Cancer

Objective: To investigate the relationship between lymphovascular invasion and clinicopathological features and prognosis in patients with invasive breast cancer.Methods: 1.A total of 2479 cases of invasive breast cancer hospitalized in the Department of Breast Surgery of the First Affiliated Hospital of Dalian Medical University from January 1,2012 to December 31,2020 were retrospectively collected and screened according to the relevant inclusion and exclusion criteria.Inclusion criteria:(1)Patients who were first hospitalized for radical breast cancer surgery(including modified radical breast cancer,extended radical breast cancer,radical breast cancer with breast preservation and breast reconstruction with nipple-areola complex preservation)and whose invasive breast cancer was confirmed by postoperative pathological and immunohistochemical tests;(2)complete clinicopathological data and follow-up data.Exclusion criteria:(1)previous mastectomy of breast masses in external hospitals;(2)patients who have undergone preoperative neoadjuvant chemotherapy and other related adjuvant treatment;(3)special types of breast cancer such as inflammatory breast cancer and Paget’s disease of the breast;(4)stage IV breast cancer;(5)bilateral invasive breast cancer;(6)patients who have undergone only segmental mastectomy or simple mastectomy due to intolerable physical status,etc.;(7)Previous history of breast tumours or tumours from other sites;(8)Missing clinicopathological data and follow-up data.A total of 2,124 patients(including 397 patients with positive lymphovascular invasion)were selected for the study.2.2,124 patients with invasive breast cancer were retrospectively analyzed for clinicopathological data,and the differences between groups in the rate of positive lymphovascular invasion according to different clinicopathological characteristics of breast cancer were analyzed using a binary unrestricted logistic regression model.The Kaplan-Meier survival curves were plotted.4.The factors that had a statistically significant effect on the 5-year OS and 5-year DFS of breast cancer in the log rank univariate survival analysis were The factors associated with a statistically significant effect on 5-year OS and 5-year DFS in the log rank univariate survival analysis were substituted into a Cox multifactor survival regression model to analyse whether this factor was an independent risk factor for the prognosis of invasive breast cancer.Results: 1.There was a strong correlation(P < 0.05)between lymphovascular invasion and tumour T-stage,number of lymph node metastases,histological grade and nerve infiltration,with the odds ratio(OR)and 95% confidence interval(95% CI)being OR histological grade = 1.713(1.312,2.237),ORT stage = 1.459(1.120,1.902),OR number of lymph node metastases = 2.578(1.992,3.337),OR nerve infiltration = 2.472(1.733,3.527);2.1.902),OR lymph node metastases = 2.578(1.992,3.337),OR nerve infiltration = 2.472(1.733,3.527);2.The 5-year overall survival rate for patients with positive lymphovascular invasion(88.5%)was lower than that for patients with negative lymphovascular invasion(95.4%),and the effect of lymphovascular invasion on the 5-year overall survival rate of breast cancer patients was not The HR and 95%confidence interval of the risk ratio for 5-year overall survival were HR=1.458(0.955,2.227);3.The 5-year disease-free survival rate of patients with positive vascular thrombosis(81.5%)was lower than that of patients with negative vascular thrombosis(93.5%),and vascular thrombosis,tumour T-stage,number of lymph node metastases and The effects of lymphovascular invasion,tumour T-stage,number of lymph node metastases and nerve infiltration on 5-year disease-free survival were statistically significant(P < 0.05),and their risk ratios HR and 95% confidence intervals on 5-year disease-free survival were HR lymphovascular invasion = 1.749(1.224,2.498),HR Tstage = 1.475(1.090,1.995),HR number of lymph node metastases = 1.335(1.012,1.760),HR nerve infiltration = 2.024(1.335,3.068).Conclusions: 1.Breast cancer lymphovascular invasion was associated with tumour T-stage,number of lymph node metastases,histological grade and nerve infiltration;2.Breast cancer lymphovascular invasion had an effect on patients’ overall survival,but was not an independent risk factor affecting overall breast cancer survival;3.Breast cancer lymphovascular invasion had an effect on patients’ disease-free survival,and breast cancer lymphovascular invasion,T-stage,number of lymph node metastases and nerve infiltration were independent risk factors for disease-free survival in breast cancer.