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Importance of endothelial markers in detection of lymphovascular invasion in carcinoma breast and its correlation with axillary lymph node metastasis

Background: Lymphovascular invasion (LVI) is one of the important prognostic factors in carcinoma breast and its accurate diagnosis is important, particularly in node-negative cases for making the decision regarding aggressive adjuvant chemotherapy. Sometimes, it becomes very difficult to diagnose LVI on routine hematoxylin and eosin (H and E) stained tissue sections. Staining with endothelial immunomarkers makes the identification easy. Aim of the Study: This study aims to compare LVI detection on H and E and immunohistochemistry (IHC) stained sections and its correlation with axillary lymph node metastasis. Materials and Methods: A total of 45 cases of invasive breast carcinoma were studied. LVI was evaluated in routine H and E and IHC stained sections. The results were compared. The LVI status on IHC was correlated with axillary lymph node status. Results: The accuracy of H and E stained sections in detection of LVI was 75.6% with a false-positive and false-negative rate of 20% and 4.4%, respectively. There was no significant association between LVI on IHC and axillary lymph node status. Conclusions: The detection of LVI on routine H and E sections can be erroneous. IHC should be done in cases with confusing focus on routine H and E stained sections, particularly in node-negative cases.