Clinicopathological significance of lymphovascular invasion in carcinoma breast and its correlation with other Prognostic markers: An experience at a tertiary care centre.

BACKGROUND: Breast cancer is a biologically diverse condition that exhibits varied clinical outcomes and responses to treatment. Its prognosis and therapeutic approach are determined by several established factors, including the patient's age, tumor dimensions and site, histological classification and grade, and lymph node involvement, all of which must be evaluated collectively to guide optimal patient care. This research focuses on identifying and assessing lymphovascular invasion (LVI) through the use of D2-40 and CD34 immunohistochemical markers, aiming to explore its pathological relevance and its association with other prognostic indicators in breast carcinoma. METHODOLOGY: This study involved thirty eight mastectomy samples confirmed to have breast carcinoma. Using hematoxylin and eosin (H&E) stained sections, along with immunohistochemical (IHC) evaluation for markers including estrogen receptor (ER), progesterone receptor (PR), HER2/neu, and the vascular endothelial markers CD34 and D2-40, the relationship between lymphovascular invasion (LVI) and various prognostic factors was examined.CD34 and D2-40 were specifically utilized to distinguish lymphatic and blood vessels from retraction artifacts, aiding in the accurate identification of LVI. Statistical analysis was done by utilizing SPSS (Statistical Package for Social Sciences) version 24.0. RESULTS: LVI had no statistical correlation with increased tumor size (P = 0.443), elevated Nottingham grade (P = 0.880), lymph node status (P = 0.420), or higher Nottingham Prognostic Index (NPI) (P = 0.733) and higher Lymph node ratio (LNR) (P = 0.097). CONCLUSION: D2-40 has emerged as a valuable immunohistochemical marker for identifying lymphatic endothelial cells. Given that lymphovascular invasion (LVI) is associated with unfavorable clinical outcomes, its assessment is essential in all cases of breast carcinoma to ensure accurate prognostication and appropriate therapeutic planning.