Correlation Between Tumor Microvessel Density and Prognosis in Breast Cancer

Yang, Kwang Soo; Lee, Kwang Man; Chae, Kwon Mook; Moon, Hyung Bae

Abstract

It has been recognized that angiogenesis has a profound effect on growth of tumors in various animal models. Recently, it was suggested that tumor microvessel density may be an independent prognostic factor in breast cancer and other human tumors. This study was designed to define the correlation between tumor microvessel density and survival in breast cancer. Pathological parameters of 60 patients with breast cancer were analyzed: stage, nodal status, histologic grade, vascular invasion, and p53 expression. Tumor microvessels were stained by the immunohistochemical method in formalin-fixed, paraffin-embedded tissues by using the anti-CD31 monoclonal antibody (JC/70A, DAKO) and were counted with in a 10 objective field (about 0.74 mm2) in the area of the most intense neovascularization. The microvessel density (MVD) of the tumor was compared with other prognostic factors and 5-year survival rate. The mean MVD of the 60 breast cancers was 36.5 15.3 (range: 17~112). The MVD did not correlate with the stage, the node metastasis, the histologic grade, the vascular invasion, or the p53 expression. The MVD was graded by the number of microvessels as grade 1 (MVD 17~32), grade 2 (MVD 33~48), and grade 3 (MVD>49). The 5-year survival rate of patients with MVD grade 1 was 69.0%, and those of grades 2 and 3 were 58.2% and 29.6%, respectively, which was statistically significant (p=0.004). By univariate analysis, the stage (p<0.001), the axillary nodal status (p<0.001), the MVD (p=0.004), and the p53 expression (p=0.041) had a significant correlation with survival. In 25 patients with node-negative breast cancer, the MVD was the single significant prognostic factor (p=0.047). These results suggest that tumor microvessel density is a significant prognostic factor in invasive breast cancer and that it may be a prognostic factor in node-negative breast cancer.