Evaluation of Lymphangiogenesis in Breast Carcinomas Using D2-40 Immunostain

Materials and MethodsSixty-five cases of carcinoma breast were studied. Various histological parameters were evaluated and subjected to immunohistochemical staining with D2-40. Thirty-six cases were also studied for hormonal receptors and (HER2/neu) expression. D2-40 expression and peritumoral and intratumoral LVDs were assessed and correlated with known prognostic factors.ResultsD2-40 showed a marked increase in detecting lymphatic invasion than on H&E staining. Statistically significant correlation was seen with grade and lymph node status. No significant correlation was seen between tumor size, hormonal receptor status and HER2/neu expression. D2-40 also demonstrated the presence of intratumoral lymphatics. In addition, a statistically significant correlation was found between intratumoral LVD and tumor grade. Intriguingly, D2-40 was expressed by cancer-associated fibroblasts (CAF) and was detected in tumors with high LVD.ConclusionD2-40 staining is a useful method for detection of LVI in breast carcinomas, and histochemical determination of LVI and LVD in tumors is considerably linked to aggressive features indicating a possibility for lymphatic spread and probable poor prognosis.