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BMC Cancer 2010
Lympho-vascular invasion in BRCA related breast cancer compared to sporadic controlsAbstract: Since BRCA1-associated breast cancers have pushing borders that prevent them from easily reaching vessels and are often of the medullary (like) type that is known to have a low rate of lympho-vascular invasion (LVI), we hypothesized that absence of LVI could characterize BRCA1 related breast cancer.A population of 68 BRCA1 related invasive breast cancers was evaluated for LVI by an experienced breast pathologist blinded to mutation status, and compared to a control group matched for age, grade and tumor type.LVI was present in 25.0% of BRCA1 related cases, compared to 20.6% of controls (P = 0.54, OR = 1.29, CI 0.58-2.78).LVI is frequent in BRCA1 germline mutation related breast cancers, but seems to occur as often in sporadic controls matched for age, grade and tumor type. Apparently, these hereditary cancers find their way to the blood and lymph vessels despite their well demarcation and often medullary differentiation.About 5-10% of all breast cancer cases are due to a hereditary predisposition. The two most important genes that, when bearing a germline mutation, predispose to breast cancer, are the BRCA1 and BRCA2 genes. It has been estimated that 5.3% of breast cancers occurring in women under forty years and 1.1% of breast cancers in women from 50 to 70 years are due to mutations in either of these genes[1]. Both genes are considered to be tumor suppressor genes that play a role in DNA repair [2-6] and mammary stem cell differentiation[7,8].Mutation carriers have an increased life-time risk of developing breast cancer of 57% and 40% and of developing ovarian cancer of 40% and 18% for BRCA1 and BRCA2 respectively[9].BRCA1 related breast carcinomas have a distinct histopathological phenotype. They have been shown to be more often of the ductal and medullary type, of high grade and to show a high mitotic activity index (MAI) and necrosis [10,11]. An expensive growth pattern is also a prominent feature of this phenotype. Pushing margins have been reported to be sig
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