"Differentiating lymphovascular invasion from retraction artifact on hi" by Nicholas George Zaorsky, Ninad Patil et al.
Differentiating lymphovascular invasion from retraction artifact on histological specimen of breast carcinoma and their implications on prognosis.
This article has been peer reviewed. It was published in: Journal of Breast Cancer.
Volume 15, Issue 4, December 2012, Pages 478-480.
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.
Zaorsky, Nicholas George; Patil, Ninad; Freedman, Gary Mitchel; and Tuluc, Madalina, "Differentiating lymphovascular invasion from retraction artifact on histological specimen of breast carcinoma and their implications on prognosis." (2012). Department of Radiation Oncology Faculty Papers. Paper 31.