Role of Adipocyte Tissue Invasion as a Prognostic Marker in Invasive Breast Carcinoma - A Cross-Sectional Study

Abstract

Background: Functional lymphatics at the peritumoral site is mainly responsible for lymphovascular invasion (LVI) in breast cancer. Marginal adipose tissue invasion (ATI) leads to larger area of contact between peritumoral lymphatics and may increase chances of LVI. Objectives: To investigate whether ATI of cancer cells at the tumour margin influenced lymph node status and prognosis in patients with invasive ductal carcinoma of the breast. Materials and methods: Cross sectional study involving 33 cases of invasive ductal carcinoma diagnosed over a duration of three years. Clinicopathologic prognostic parameters in 33 cases with marginal ATI was were compared 10 patients without ATI. The value of the combination of ATI and peritumoral lymphatic vessel invasion (LVI) was also assessed. Chi square was applied to assess the statistical significance at p<0.05. Results: The frequency of axillary lymph node metastases was 63.63.7% in patients with ATI (21/33) and 0% in patients without ATI (0/10) with a p value of < .001. The frequency of peritumoral lymphovascular invasion was 88.88% in patients with ATI (24/27) and 11.1% in patients without ATI (3/27) with a p value of < 0.01. ATI was an independent factor influencing nodal metastasis. Conclusion: ATI of cancer cells at the tumour margin is one of the biologic indicators of tumour aggressiveness in invasive breast cancer. This study indicate that ATI+ cases were associated with adverse outcomes in addition to the converse. ATI should be incorporated in a standard surgical pathology report of infiltrating ductal carcinoma of the breast as ATI and peritumoral LVI will be useful in the framing therapeutic strategies and in assessment of prognosis.

Keywords

• adipocyte tissue
• breast cancer
• lympho vascular invasion
• metastasis