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KMID : 1134120120150040478
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Journal of Breast Cancer
2012 Volume.15 No. 4 p.478 ~ p.480
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Differentiating Lymphovascular Invasion from Retraction Artifact on Histological Specimen of Breast Carcinoma and Their Implications on Prognosis
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Zaorsky Nicholas George
Patil Ninad
Freedman Gary Mitchel
Tuluc Madalina
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Abstract
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On a pathological specimen of breast cancer cells, retraction artifact during histological processing mimics true lymphovascular invasion (LVI). The accurate determination of the presence or absence of LVI is a factor in determining risk of having a positive sentinel node, or having additional positive axillary nodes after a positive sentinel node biopsy in women with early-stage breast cancer. The determination of nodal risk influences the decision of the treating physicians as to whether a sentinel node biopsy or completion axillary dissection is necessary. On slide preparation, ideal factors favoring true LVI include: a definite endothelial lining, with endothelial nuclei that seem to protrude into the lymphatic space; invasion in one lymphatic vessel (LV) lumen with nearby cancer glands that have minimal or no retraction; a tumor embolus in a LV clear lumen with outside nearby tumor bulk; a tumor embolus that is different in shape than its surrounding clear LV space; and a positive stain for fibrin, CD31, or CD34 on tumor embolus periphery.
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KEYWORD
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Breast neoplasms, Diagnosis, Pathology
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