Adverse prognostic value of peritumoral vascular invasion: Is it abrogated by adequate endocrine adjuvant therapy? Results from two international breast cancer study group randomized trials of chemoendocrine adjuvant therapy for early breast cancer

G. Viale, A. Giobbie-Hurder, B. A. Gusterson, E. Maiorano, M. G. Mastropasqua, A. Sonzogni, E. Mallon, M. Colleoni, M. Castiglione-Gertsch, M. M. Regan, K. N. Price, R. W. Brown, R. Golouh, D. Crivellari, P. Karlsson, C. Ö Hlschlegel, R. D. Gelber, A. Goldhirsch, A. S. Coates

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Peritumoral vascular invasion (PVI) may assist in assigning optimal adjuvant systemic therapy for women with early breast cancer. Patients and methods: Patients participated in two International Breast Cancer Study Group randomized trials testing chemoendocrine adjuvant therapies in premenopausal (trial VIII) or postmenopausal (trial IX) node-negative breast cancer. PVI was assessed by institutional pathologists and/or central review on hematoxylin-eosin-stained slides in 99% of patients (analysis cohort 2754 patients, median follow-up >9 years). Results: PVI, present in 23% of the tumors, was associated with higher grade tumors and larger tumor size (trial IX only). Presence of PVI increased locoregional and distant recurrence and was significantly associated with poorer disease-free survival. The adverse prognostic impact of PVI in trial VIII was limited to premenopausal patients with endocrine-responsive tumors randomized to therapies not containing goserelin, and conversely the beneficial effect of goserelin was limited to patients whose tumors showed PVI. In trial IX, all patients received tamoxifen: the adverse prognostic impact of PVI was limited to patients with receptor-negative tumors regardless of chemotherapy. Conclusion: Adequate endocrine adjuvant therapy appears to abrogate the adverse impact of PVI in node-negative disease, while PVI may identify patients who will benefit particularly from adjuvant therapy.

Original languageEnglish
Pages (from-to)245-254
Number of pages10
JournalAnnals of Oncology
Volume21
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • Adjuvant therapy
  • Breast cancer
  • Endocrine responsiveness
  • Metastasis
  • Prognosis
  • Vascular invasion

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Medicine(all)

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