Microvessel quantitation and prognosis in invasive breast carcinoma

doi:10.1016/0046-8177(92)90344-3

Human Pathology

Volume 23, Issue 7, July 1992, Pages 755-761

https://doi.org/10.1016/0046-8177(92)90344-3 Get rights and content

Abstract

The prognostic significance of microvessel quantitation in invasive breast carcinoma was analyzed in a study group that comprised 88 patients with axillary node-negative carcinoma and 32 patients with axillary node-positive carcinoma who had a minimum follow-up period of 9 years. Microvessels were identified by immunohistochemistry using antibodies to endothelial markers, including factor VIII-related antigen and blood group isoantigens (ABH). Factor VIII-related antigen staining provided more consistent results for microvessel quantitation than did staining for ABH isoantigens. The three most vascular areas within a tumor were selected, and the microvessels within a ×200 microscopic field of each area were counted by two investigators simultaneously. Node-positive carcinomas demonstrated significantly higher microvessel counts than did node-negative carcinomas (mean ± SD, 99 ± 42 and 73 ± 22, respectively; P < .001). In node-negative carcinomas, tumors from patients who experienced distant recurrence had higher microvessel counts than did tumors from patients who were disease-free (84 ± 19 and 70 ± 22; P = .01). Similarly, in patients with node-positive carcinoma, microvessel counts were considerably higher in tumors from patients who experienced distant recurrence than in patients who did not, although the difference did not reach statistical significance (113 ± 44 and 93 ± 34, respectively). Among patients with node-negative carcinoma, those with a microvessel count of less than 84 had a recurrence rate of 20% compared with 57% in patients with counts greater than 84 (P = .003). Microvessel counts were independent of histologic parameters, ploidy status, and S-phase fraction but correlated with peritumoral vascular invasion. Both microvessel counts and vascular invasion were independent prognostic parameters by multivariate analysis. High vessel counts may represent increased tumor angiogenesis and are correlated with tumor aggressiveness. Microvessel quantitation may be an additional prognostic factor that, when used in conjunction with more established parameters, can help in appropriate patient management.

References (24)

EV Sugarbaker
Cancer metastasis: A product of tumor-host interactions
Curr Probl Cancer
(1979)
LA Liotta et al.
Cancer metastasis and angiogenesis: An imbalance of positive and negative regulation
Cell
(1991)
WL McGuire
Adjuvant therapy of node-negative breast cancer
N Engl J Med
(1989)
VT DeVita
Breast cancer therapy: Exercising all our options
N Engl J Med
(1989)
WL McGuire et al.
How to use prognostic factors in axillary node-negative breast cancer patients
J Natl Cancer Inst
(1990)
CL Carter et al.
Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases
Cancer
(1989)
HJ Bloom et al.
Histological grading and prognosis in breast cancer: A study of 1409 cases of which 359 have been followed for 15 years
Br J Cancer
(1957)
CW Elston
Grading of invasive carcinoma of the breast
AKC Lee et al.
Prognostic significance of peritumoral lymphatic and blood vessel invasion in node-negative carcinoma of the breast
J Clin Oncol
(1990)
N Weidner et al.
Tumor angiogenesis and metastasis: Correlation in invasive breast carcinoma
N Engl J Med
(1991)

A Srivastava et al.

The prognostic significance of tumor vascularity in intermediate-thickness (0.76–4.0 mm thick) skin melanoma: A quantitative histologic study

Am J Pathol

(1988)

AK Lee

Basement membrane and endothelial antigens: Their role in evaluation of tumor invasion and metastasis

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In the present study, the mean MVD was 145 vessels/mm2, higher than that reported in other studies such as that by Kanjanapanjapol et al,12 but lower than that reported by Biesaga et al,13 in which the mean MVD was 182.9 vessels vessels/mm2. Although studies have reported significant correlations between the vessel count and tumor size in patients with breast cancer, in our study, the MVD did not increase in proportion to the tumor size.14-16 The results of the present study, however, showed a significantly greater MVD for grade 3 tumors than for grade 2 and 1 tumors, which has not been reported by any previous studies.
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^☆: Supported in part by the Eleanor Naylor Dana Charitable Trust Foundation, New York, NY, and by the National Cancer Institute, grant no. CA 40395.

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Original contributionMicrovessel quantitation and prognosis in invasive breast carcinoma☆

Abstract

Curr Probl Cancer

Cell

Adjuvant therapy of node-negative breast cancer

N Engl J Med

Breast cancer therapy: Exercising all our options

N Engl J Med

How to use prognostic factors in axillary node-negative breast cancer patients

J Natl Cancer Inst

Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases

Cancer

Histological grading and prognosis in breast cancer: A study of 1409 cases of which 359 have been followed for 15 years

Br J Cancer

Grading of invasive carcinoma of the breast

Prognostic significance of peritumoral lymphatic and blood vessel invasion in node-negative carcinoma of the breast

J Clin Oncol

Tumor angiogenesis and metastasis: Correlation in invasive breast carcinoma

N Engl J Med

The prognostic significance of tumor vascularity in intermediate-thickness (0.76–4.0 mm thick) skin melanoma: A quantitative histologic study

Am J Pathol

Basement membrane and endothelial antigens: Their role in evaluation of tumor invasion and metastasis

Original contribution
Microvessel quantitation and prognosis in invasive breast carcinoma☆