Angiogenesis as an independent prognostic indicator in node-negative breast cancer.
OBJECTIVE
To quantitate tumor angiogenesis in carcinoma of the breast (stage T2N0M0) by computerized image analysis of CD-31-stained histologic sections and, keeping in view the heterogeneity of tumors, to assess which areas of neovascularization provide the best prognostic indicator.


METHODS
Thirty-six cases of infiltrating duct carcinoma of the breast, stage T2N0M0, with follow-up of five years, were analyzed. All cases had received uniform initial treatment in the form of mastectomy with axillary clearance and radiotherapy. Intratumoral microvessel density (IMD) counts were done on "hot spots" and "non-hot spots" on CD-31-stained sections using computerized image analysis. Angiogenesis was correlated with other variables, such as age, menopausal status, histologic grade and proliferative activity by univariate and multivariate analyses.


RESULTS
Hot-spot IMD counts were highly significant independent prognostic markers in univariate and multivariate analyses. Background vascularity of a tumor was of no value in prognosticating.


CONCLUSIONS
In patients with node negative breast carcinoma, IMD counts in hot spots are an independent prognostic factor in disease-free and overall survival and can be used to separate out patients with T2N0M0 stage in need of systemic adjuvant therapy.
Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Rajan
R
Arora
Kusum
K
Joshi
Raje
R
Nijhawan
Bishan D
BD
Radotra
Suresh C
SC
Sharma
D001943:Breast Neoplasms / Q000737:chemistry / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
D018809:Proliferating Cell Nuclear Antigen