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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

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

In: Annals of Oncology, 2009, vol. 21, no. 2, p. 245-254

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    Title
    • 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
    Author
    • Viale, G.. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy
    • Giobbie-Hurder, A.. International Breast Cancer Study Group, Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA
    • Gusterson, B. A.. Division of Cancer Sciences and Molecular Pathology, Faculty of Medicine, University of Glasgow, Glasgow, UK
    • Maiorano, E.. Department of Pathological Anatomy, University of Bari, Bari, Italy
    • Mastropasqua, M. G.. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy
    • Sonzogni, A.. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy
    • Mallon, E.. Division of Cancer Sciences and Molecular Pathology, Faculty of Medicine, University of Glasgow, Glasgow, UK
    • Colleoni, M.. Department of Medicine, Research Unit in Medical Senology, European Institute of Oncology, Milan, Italy
    • Castiglione-Gertsch, M.. International Breast Cancer Study Group Coordinating Center, Bern, Switzerland
    • Regan, M. M.. International Breast Cancer Study Group, Statistical Center, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA, USA
    • Price, K. N.. International Breast Cancer Study Group, Statistical Center, Frontier Science and Technology Research Foundation, Boston, MA, USA
    • Brown, R. W.. Melbourne Pathology, Collingwood, Victoria, Australia
    • Golouh, R.. Department of Pathology, Institute of Oncology, Ljubljana, Slovenia
    • Crivellari, D.. Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy
    • Karlsson, P.. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
    • Öhlschlegel, C.. Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland
    • Gelber, R. D.. International Breast Cancer Study Group, Statistical Center, Dana-Farber Cancer Institute, Frontier Science and Technology Research Foundation, Harvard School of Public Health, Boston, MA, USA
    • Goldhirsch, A.. European Institute of Oncology, Milan, Italy
    • Coates, A. S.. Scientific Committee, International Breast Cancer Study Group, Bern, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Annals of Oncology, 2009, vol. 21, no. 2, p. 245-254. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:294468
    Summary
    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