Assessment of tumor angiogenesis in invasive breast carcinomas: absence of correlation with prognosis and pathological factors

Fridman, Viviana; Humblet, Chantal; Bonjean, Karine; Boniver, Jacques

doi:10.1007/s004280000292

Cited by 37 publications

(27 citation statements)

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“…In spite of the findings in our previous investigations, when the grade of angiogenesis was statistically related to the enhancement parameters, neither FVIII-nor CD-34-based vessel counts showed any association with disease-free and overall survival in the present study. This supports the view that morphologic evaluation of vascular density often fails to demonstrate an association with patients' survival due to the vascular heterogeneity of tumors (7).…”

Section: Discussionsupporting

confidence: 80%

Can contrast-enhanced MR imaging predict survival in breast cancer?

Boné

Szabó

Perbeck³

et al. 2003

Acta Radiol

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Purpose: To investigate the value of pre-operative contrast-enhanced MR imaging (CE-MRI) in predicting the disease-free and overall survival in breast cancer.Material and Methods: The study population consisted of 50 consecutive patients with histopathologically verified primary breast cancer who preoperatively underwent CE-MRI examination between 1992 and 1993. A threetime point MR examination was performed where the enhancement rates (C 1 and C 2 ), signal enhancement ratio (SER ¼ C 1 /C 2 ) and washout (W ¼ C 1 -C 2 ) were calculated. The relation of these MR parameters to disease-free and overall survival was investigated. The median follow-up for surviving patients was 95 months. Univariate and multivariate statistical analyses were performed to evaluate the impact of different factors on prediction of survival.Results: Of the MR parameters examined at univariate analysis, increased C 1 (p ¼ 0.029), W (p ¼ 0.0081) and SER values (p ¼ 0.0081) were significantly associated with shorter disease-free survival, and only C 1 (p ¼ 0.016) was related significantly to overall survival. Multivariate analysis for disease-free survival showed that the SER (p ¼ 0.014) and tumor size (p ¼ 0.001) were significant and independent predictors. Age (p ¼ 0.003), lymph node status (p ¼ 0.014), tumor size (p ¼ 0.039) and proliferating cell nuclear antigen index (p ¼ 0.053) remained independently associated with overall survival at multivariate analysis. C 1 was not confirmed as an independent predictor of overall survival.Conclusion: Our findings support the presumption that CE-MRI is useful in predicting the disease-free survival in patients with breast cancer.The conventional TNM classification system for staging of breast cancer is widely used to determine treatment and provides prognostic information (1). The pre-operative staging is based on a combination of clinical and imaging findings and includes the assessment of tumor extent, multifocality and lymph node status. Mammography and breast ultrasonography, however, often underestimate the extent of the disease. MR imaging has been introduced as a complementary diagnostic tool for the detection of breast cancer. It is widely accepted that MR imaging can reveal mammographically occult breast malignancy, and has the ability to determine tumor size and exclude multifocality more accurately than standard breast imaging methods (2). Recently, MR imaging has also been suggested for pre-operative loco-regional staging, as well as for the evaluation of response to preoperative chemotherapy (8,14).Although staging is very important in the clinical management and contains information on tumor size and nodal involvement, treatment planning and prediction of prognosis cannot be made without the assessment of other postoperative morphologic variables such as histologic type and malignancy grade. Besides these classic prognostic factors, a number of biological markers have also

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Section: Discussionsupporting

confidence: 80%

Can contrast-enhanced MR imaging predict survival in breast cancer?

Boné

Szabó

Perbeck³

et al. 2003

Acta Radiol

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“…Considering conventional histological prognostic factors, increased microvessel density had been reported in a number of studies to correlate with larger tumor size (Bolat et al, 2006;Thielemann et al, 2008;Thorat et al, 2009), higher tumor grade (Lee et al, 2002;Valkovic et al, 2002;Bolat et al, 2006;Vogl et al, 2006;Zhou et al, 2006;Thorat et al, 2009) and lymph node metastasis (Weidner et al, 1991;Valkovic et al, 2002;Lee et al, 2002;Bolat et al, 2006). In other studies, however, relationships with these histological prognostic factors could not be validated (Miliaras et al, 1995;Gasparini et al, 1996;Acenero et al, 1998;Fridman et al, 2000;Koukourakis et al, 2003;Ludovini et al, 2003). Similarly, in this study, no significant difference in microvessel density was detected in reference to these histological prognostic factors (p>0.05).…”

Section: Microvessel Density In Invasive Breast Ductal Carcinoma Noscontrasting

confidence: 73%

Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis

Ch’ng

Sharif²,

Jaafar³

2012

Asian Pacific Journal of Cancer Prevention

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Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.

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“…Some studies identify the cutoff value as the average number of microvessels (9,27), but in other studies, the cut-off value is the median number of microvessels (10,40). There are also some other studies accepted absolute values as the cut-off value (36,41,42).…”

Section: Discussionmentioning

confidence: 99%

Comparison of microvessel density with prognostic factors in invasive ductal carcinomas of the breast

Şener¹,

Şipal²,

Gündoğdu³

2016

TJPATH

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Objective: Angiogenesis plays a key role in tumor growth and metastasis. Determination of microvessel density is the most common technique used to evaluate the amount of the intratumoral angiogenesis in breast cancer. We have aimed to investigate the relationship with tumor angiogenesis and prognostic parameters in breast invasive ductal carcinomas. Material and Method:In this study, a total of 100 invasive ductal carcinoma patients, who were diagnosed at the Department of Pathology, Ataturk university Faculty of medicine between the years 2003-2008, were re-evaluated. Patient characteristics and clinicopathological findings were obtained from archival records. In the present study, microvessel density was determined by immunohistochemical staining by using anti-CD34 monoclonal antibody in the paraffin blocks. First, the most vascular area was selected in the tumor under a low magnification (40x) by a light microscope and then microvessels were counted under a higher magnification (200x). Patients were classified as low and high microvessel density depending on their microvessel counts. Chi-square test and multivariate linear regression analysis were used for statistical analysis (p≤0.05). Results:We have determined that microvessel density increases as tumor size increases (p=0.001). microvessel density was higher in patients with at least 10 lymph node metastases compared to those with no metastasis (p=0.05). However, there was no statistically significant difference between microvessel density and other prognostic factors such as histological grade, nuclear grade, patient age, vascular invasion, estrogen, progesterone receptor status, HEr2/neu expression. Conclusion:In our study, we have found that microvessel density is associated with tumor size and lymph node metastasis in patients with invasive ductal carcinoma.

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Assessment of tumor angiogenesis in invasive breast carcinomas: absence of correlation with prognosis and pathological factors

Cited by 37 publications

References 38 publications

Can contrast-enhanced MR imaging predict survival in breast cancer?

Can contrast-enhanced MR imaging predict survival in breast cancer?

Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis

Comparison of microvessel density with prognostic factors in invasive ductal carcinomas of the breast

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