title: Changes in microvessel density as assessed by CD34 antibodies after primary chemotherapy in human breast cancer.
abstract: BACKGROUND
  Several papers have shown that quantitationof tumor angiogenesis in primary breast cancer by counting blood vessels gives an independent assessment of prognosis. The impact of chemotherapy +/- endocrine therapy on the extent of angiogenesis is unknown.
  
  
  METHODS
  Matched pair histological tumor samples were obtained before and after primary chemotherapy from 120 breast cancer patients recruited in the same institution. The first 55 cases received cyclophosphamide, methotrexate, and 5-fluorouracil +/- Tamoxifen, whereas the subsequent 65 were submitted to single agent epirubicin. Patients underwent an incisional biopsy at diagnosis and definitive surgery on completion of three or four chemotherapy cycles. Microvessel density (MVD) was performed after staining with the CD34 monoclonal antibody.
  
  
  RESULTS
  MVD slightly decreased after chemotherapy [median 51.26 mm(2) (range 2.33-163.1) and 44.27 mm(2) (2.33-121.16; P < 0.001)]; this small reduction neither correlated with tumor response nor with changes in Ki67 expression. MVD at baseline significantly correlated with MVD assessed at definitive surgery (Spearman r = 0.70, P < 0.001). In multivariate analysis, c-erbB2 status showed an independent role in predicting the reduction in MVD that just failed to attain the statistical significance (P = 0.08), whereas baseline parameters, such as T, N, steroid hormone receptor, bcl-2, p53, c-erbB2, and Ki67 expression, did not enter the model.
  
  
  CONCLUSIONS
  Primary chemotherapy is able to modestly reduce the MVD in breast tumors. This small change is not biologically important, because the baseline neoangiogenesis status is not substantially changed. The change in microvessel count after chemotherapy could be potentially influenced by the c-erbB2 status.
authors.affiliation: Breast Cancer Unit, Azienda Ospedaliera Istituti Ospitalieri, Cremona, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bottini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berruti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bersiga
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Brizzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Allevi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Bolsi
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguggini
authors.forename: Antonio
authors.initials: A
authors.lastname: Brunelli
authors.forename: Enrico
authors.initials: E
authors.lastname: Betri
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.forename: Lorena
authors.initials: L
authors.lastname: Scaratti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bertoli
authors.forename: Palmiro
authors.initials: P
authors.lastname: Alquati
authors.forename: Luigi
authors.initials: L
authors.lastname: Dogliotti
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000378:metabolism*; D018952:Antigens, CD34 / Q000276:immunology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007124:Immunoenzyme Techniques; D019394:Ki-67 Antigen / Q000378:metabolism; D008727:Methotrexate / Q000008:administration & dosage; D008833:Microcirculation; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000378:metabolism* / Q000473:pathology; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D015996:Survival Rate; D013629:Tamoxifen / Q000008:administration & dosage; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D018952:Antigens, CD34; D003520:Cyclophosphamide; D015251:Epirubicin; D005472:Fluorouracil; D019394:Ki-67 Antigen; D008727:Methotrexate; D019253:Proto-Oncogene Proteins c-bcl-2; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen; D016159:Tumor Suppressor Protein p53