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Prognostic Significance of Intratumoral and Peritumoral Lymphatic Density and Blood Vessel Density in Invasive Breast Carcinomas

Yasser M. El-Gohary MD, Ghada Metwally MD, Reda S. Saad MD, PhD, Morton J. Robinson MD, Thomas Mesko MD, Robert J. Poppiti MD
DOI: http://dx.doi.org/10.1309/2HGNJ1GU57JMBJAQ 578-586 First published online: 1 April 2008


We studied tumor lymphatic and vascular densities and lymphovascular invasion (LVI) as prognostic markers in 48 cases of invasive breast cancer treated with partial or total mastectomy and lymph node dissection. All cases were immunostained with D2–40 and CD31. Positively stained microvessels were counted in densely vascular/lymphatic foci (hot spots) at ×400. The mean ± SD peritumoral lymphatic microvessel density (LMD) was significantly higher than intratumoral LMD (9 ± 7 vs 4 ± 6; P < .01). There was a positive correlation of D2–40 LMD (peritumoral and intratumoral) and CD31 microvessel density counts with lymph node metastasis (r = 0.35, 0.5, and 0.38), nuclear grade (r = 0.36, 0.28, and 0.3), and stage (r = 0.42, 0.56, and 0.49), respectively. Peritumoral and intratumoral D2–40 LMD correlated significantly with the presence of angiolymphatic invasion (detected by D2–40; r = 0.54 and 0.54, respectively). D2–40 detected more LVI than H&E- and CD31-detectable vascular invasion (18/48, 5/48, 11/48, respectively). Increased D2–40 detected LVI, and high CD31 microvessel counts showed significant adverse effect on survival status.

Key Words:
  • Invasive breast carcinoma
  • Lymphatics
  • Blood
  • Microvessels
  • Density