The relationship of peritumoral lymphatic vessel density, marginal adipose tissue invasion and clinicopathological parameters in breast carcinoma

Objective: To investigate a possible association between peritumoral lymphatic vessel density (LVD) and adipose tissue invasion (ATI) of cancer cells at the tumor margin and their correlation with other prognostic parameters in breast cancer, including lymph node status. Material and methods: Data of 75 patients with breast carcinoma were evaluated through combination of peritumoral LVD and ATI at the tumor margin and compared with clinicopathological parameters. Peritumoral LVD was assessed by immunostaining for D2-40 using the Chalkley counting method. Marginal ATI was defined as either the presence of more than 20 cancer cells in direct contact with the adipose tissue or as the presence of cancer cells in the adipose tissue. Cases were evaluated concerning to patient’s age, tumor size using the TNM staging system, histological type, histological grade (Nottingham histological score, Elston and Ellis), lymphovascular invasion, lymph node metastasis, estrogen receptor (ER), progesterone receptor (PR), HER2/neu status and Ki-67. Results: The relationship was identified between LVD and marginal ATI but without statistical significancy (r = -0,207; p=0,113). There was a significant correlation of the marginal ATI with Ki-67 expression (r=0,250; p =0.03). The regression model (all variables according to ATI) showed a significant total effect (p <0.05), where Ki-67 was an only independent indicator of ATI. Conclusion: The present study suggests that adipose tissue invasion of cancer cells at the tumor margin can be a better predictive biologic indicator of aggressiveness than peritumoral lymphatic vessel density in breast carcinoma. Keywords: breast carcinoma, peritumoral lymphatic vessel density, marginal adipose tissue invasion.