Prognostic Role of Lymphovascular Invasion and Perineural Invasion in Breast Cancer Treated with Neoadjuvant Chemotherapy

Abstract

In our study, we investigated the predictive properties of LVI (lymphovascular invasion) and PNI (perineural invasion) on survival times from pathology specimens obtained from surgical operation after neoadjuvant chemotherapy (NAC) with breast cancer patients. Two hundered eleven female patients were included in this study. We evaluated the relationship between potential prognostic factors and mean recurrence-free survival (RFS) and overall survival (OS) times using Kaplan-Meier methodology and Cox proportional hazard modelling.The mean follow-up time was 27.3 months.PNI positive patients had shorter RFS and OS times than PNI negatives (p< 0.001, p= 0.002, respectively), and LVI positive patients had shorter RFS and OS times than LVI negatives (p< 0.001, p< 0.001, re-spectively). In the multivariate analysis performed, the presence of pN stage and PNI were found to be predictive for RFS (p= 0.047, p< 0.001, respectively), while pT stage and PNI positivity were found to be predictive for OS (p= 0.035, p= 0.017, respectively). LVI did not show the property of being an independent predictive marker for survival. PNI caused significant survival differences in all subtypes for both RFS (log-rank p< 0.001, p= 0.003, p= 0.001, respectively) and OS(log-rank p= 0.035, p= 0.006, p= 0.020 respectively) in HR+/Her2-, Her2+ and Triple negative breast cancer subtyping. LVI, on the other hand, caused survival distribution difference for RFS (p= 0.021) in the HR+/Her2-subtype and for both RFS and OS in the Triple-negative subtype (p< 0.001, p= 0.025, respectively). PNI is strongly and significantly associated with RFS and OS. We suggest that it can be used in identifying high-risk patients for recurrence of PNI and in new staging systems.