Lymphatic and blood vessels in basal and triple-negative breast cancers: characteristics and prognostic significance
Open accessAbstract
Basal and triple-negative breast cancer phenotypes are characterised by unfavourable biological behaviour and outcome. Although certain studies have examined their pathological and molecular profile, the vascular characteristics of lymphatic and blood vessels have not been examined. Immunohistochemical staining with podoplanin, CD34 and CD31 was used to examine lymphatic and microvessel density, as well as vascular invasion in 197 basal-like and in 99 triple-negative breast tumours and compared against 200 non-basal and 334 non-triple-negative cases. All specimens were lymph node negative. Vascular invasion was identified as blood or lymphatic vascular invasion by the differential expression of markers. All measurements were correlated with clinicopathological features and prognosis. No significant difference was detected between the basal and triple-negative groups in terms of lymphatic or microvessel density or vascular invasion. However, both the basal and the triple-negative groups showed significantly higher microvessel density than did the non-basal and non-triple-negative groups (P=0.017 and P<0.001, respectively). Unlike microvessel density, no significant difference was detected in lymphatic density between the basal or triple-negative groups compared with their respective controls. Interestingly, vascular invasion, almost entirely lymphatic invasion, was detected in 27% of the basal and in 26% of the triple-negative groups with no significant difference in comparison with control groups. In both basal and triple negatives, vascular invasion was associated with poorer survival by univariate and multivariate analyses. The 20-year overall survival rate in basal-like tumours was 55% in vascular invasion-positive cases compared with 73% in vascular invasion-negative tumours (P=0.012), and 46% in triple-negative vascular invasion-positive compared with 79% in vascular invasion-negative tumours (P=0.001). Basal-like vs non-basal-like and triple-negative vs non-triple-negative tumours have similar vascular characteristics in terms of lymphatic vessel density and vascular invasion but higher microvessel density, suggesting that such groups may preferentially benefit from anti-angiogenic therapy. Vascular invasion was, in all phenotypes, almost entirely lymphatic vessel invasion and could stratify basal-like and triple-negative phenotypes into distinct prognostic groups.
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The results on the histological class pairs associated with pCR and RD are in line with previously published studies.
“These results are in line with previously published studies [58–66].”
From Digital image analysis and machine learning-assisted prediction of neoadjuvant chemotherapy response in triple-negative breast cancer (2024) · cites this paper as [63]
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- Authors
- Mohammed, R. A. A., Ellis, I. O., Mahmmod, A. M., Hawkes, E. C., Green, A. R., Rakha, E. A., & Martin, S. G.
- Affiliations
- University of Nottingham (GB)
- Nottingham University Hospitals NHS Trust (GB)
- Corresponding author
- Mohammed, Rabab A A
- Martin, Stewart G
- Venue
- Modern Pathology
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 24
- Issue
- 6
- Pages
- 774-785
- ISSN
- 0893-3952 (ISSN-L)
- OpenAlex
- W2041497771
- Cited by
- 145
- References
- 51
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 8 · 2023: 14 · 2022: 17 · 2021: 12 · 2020: 14 · 2019: 13 · 2018: 5 · 2017: 11 · 2016: 7 · 2015: 8 · 2014: 6 · 2013: 6 · 2012: 9
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Modern Pathology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cancer Research UK (C20420/A9967)
- Assiut University
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Oncology › Lymphatic System and Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Keywords
- basal-like breast cancer, triple-negative breast cancer, lymphatic vessel density, microvessel density, vascular invasion, lymphatic invasion, podoplanin, CD34, CD31, prognostic factors, overall survival, anti-angiogenic therapy, node-negative breast cancer
- MeSH terms
- Blood Vessels, Breast Neoplasms, Female, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Neovascularization, Pathologic, Prognosis, Receptors, Estrogen, Receptors, Progesterone, Biomarkers, Tumor, Survival Rate, Receptor, ErbB-2, Erb-b2 Receptor Tyrosine Kinases, Lymphangiogenesis, Lymphatic Vessels
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