Perineural invasion as a risk factor for locoregional recurrence of invasive breast cancer

• Published in: Scientific reports 2021-06, Vol.11 (1), p.12781-12781, Article 12781
• Main Authors: Narayan, Priyanka, Flynn, Jessica, Zhang, Zhigang, Gillespie, Erin F., Mueller, Boris, Xu, Amy J., Cuaron, John, McCormick, Beryl, Khan, Atif J., Cahlon, Oren, Powell, Simon N., Wen, Hannah, Braunstein, Lior Z.
• Format: Article
• Language: English
• Subjects: 631/67/1059; 631/67/1347; Adult; Aged; Aged, 80 and over; Breast cancer; Breast Neoplasms - pathology; Cancer therapies; Chemotherapy; Cohort Studies; Decision making; ErbB-2 protein; Estrogen receptors; Estrogens; Female; Humanities and Social Sciences; Humans; Invasiveness; Middle Aged; multidisciplinary; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Peripheral Nerves - pathology; Progesterone; Regression analysis; Risk Factors; Science; Science (multidisciplinary); Solid tumors; Young Adult
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-92343-4

Perineural invasion (PNI) is a pathologic finding observed across a spectrum of solid tumors, typically with adverse prognostic implications. Little is known about how the presence of PNI influences locoregional recurrence (LRR) among breast cancers. We evaluated the association between PNI and LRR among an unselected, broadly representative cohort of breast cancer patients, and among a propensity-score matched cohort. We ascertained breast cancer patients seen at our institution from 2008 to 2019 for whom PNI status and salient clinicopathologic features were available. Fine-Gray regression models were constructed to evaluate the association between PNI and LRR, accounting for age, tumor size, nodal involvement, estrogen receptor (ER), progesterone receptor (PR), HER2 status, histologic tumor grade, presence of lymphovascular invasion (LVI), and receipt of chemotherapy and/or radiation. Analyses were then refined by comparing PNI-positive patients to a PNI-negative cohort defined by propensity score matching. Among 8864 invasive breast cancers, 1384 (15.6%) were noted to harbor PNI. At a median follow-up of 6.3 years, 428 locoregional recurrence events were observed yielding a 7-year LRR of 7.1% (95% CI 5.5–9.1) for those with PNI and 4.7% (95% CI 4.2–5.3; p = 0.01) for those without. On univariate analysis throughout the entire cohort, presence of PNI was significantly associated with an increased risk of LRR (HR 1.39, 95% CI 1.08–1.78, p