The changing pattern of recurrence in oestrogen positive and negative breast cancer with nodal spread, related to efferent vascular invasion.

In a series of 50 cases of node-positive breast carcinoma, 11 of 26 of those with efferent vascular invasion (EVI) in the axillary nodes at the time of operation were dead 3 years later, in contrast to 1 of 24 EVI-negative. Recurrence within the 1st year was more common in the cases with an oestrogen receptor (ER) negative primary, but by the 3rd year this trend had reversed, and there were more recurrences in the ER-positive. While recurrence and death came earlier in EVI + ER - cases, the EVI + ER + followed soon after. Next came recurrence and death in the EVI - ER +, while there have been no deaths to date in the EVI - ER -. A model is proposed to explain the timing of recurrence in these different groups.