Author(s)

Paul H. Levine^1*, Heather J. Hoffman¹, Audra MacNeil¹, Salman Hashmi¹, Sherry X. Yang², Stephen Hewitt³, Kenneth L. van Golen⁴, Sandra M. Swain⁵

¹Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington DC, USA.
²National Clinical Target Validation Laboratory, Division of Cancer Treatment & Diagnosis, National Cancer Institute, Bethesda, USA.
³Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, USA.
⁴Department of Biological Sciences, Center for Translational Cancer Research, The University of Delaware, Newark, USA.
⁵Washington Cancer Institute, MedStar Washington Hospital Center, Washington DC, USA.

Background: We recently evaluated four laboratory assays, vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE), which showed notable differences between inflammatory breast cancer (IBC) and non-inflammatory locally advanced breast cancer (LABC). In this study we investigated the potential of the three most quantitatively measured markers, E-cadherin, LVD and VEGF-D, to predict survival in the IBC patients. Materials and Methods: This study involved the 100 cases identified in the Inflammatory Breast Cancer Registry (IBCR) whose tumors were previously evaluated for the four assays noted above. Living patients were recontacted and survival data were available for up to 17 years. Overall survival (OS) was analyzed through the Kaplan-Meier method stratified by E-cadherin, LVD, VEGF-D, and response to chemotherapy. The differences in OS curves were compared using the log-rank test. Results: The median OS for patients with high LVD was 6.63 years (95% CI: 4.06 to 10.14), compared to median at 10 years not reached in those with low LVD (p = 0.03). There was a trend towards a longer median OS in patients with high E-cadherin (10.14, 95% CI: 6.63 to 11.67), compared with those with low E-cadherin (6.26, 95% CI: 3.42 to undeterminable). VEGF-D levels showed no correlation with survival. Conclusion: Low LVD significantly predicts better survival. High E-cadherin expression, as with non-IBC breast cancer and several other malignancies, tends to be associated with a better prognosis.

IBC, Prognostic Markers, E-Cadherin, Lymphocyte Vascular Density

Levine, P. , Hoffman, H. , MacNeil, A. , Hashmi, S. , Yang, S. , Hewitt, S. , Golen, K. and Swain, S. (2014) Prognostic Value of Lymphocyte Vascular Density and E-Cadherin in Inflammatory Breast Cancer. Journal of Cancer Therapy, 5, 1380-1387. doi: 10.4236/jct.2014.514139.