Assessment of breast cancer vascularisation by Doppler ultrasound as a prognostic factor of survival.
Tumor growth and metastasis in breast cancer are correlated to neoangiogenesis, which became a potential candidate as a prognostic factor in this tumor type. Several studies have used immunohistochemical staining to count microvessel density as a marker of neoangiogenesis. This hospital-based retrospective pilot study measured vascularisation of early breast cancer by Doppler ultrasound and determined its value as a prognostic factor of overall survival in 147 women. The number of tumor related arteries were detected by color-coded Doppler ultrasound. We identified < or =10 tumor arteries and >10 tumor arteries in 117 and 30 women, respectively. Only weak correlation was found between the number of tumor arteries and established clinicopathological parameters such as tumor size (r=0.25) and lymph node involvement (r=0.13). In an univariate analysis, the strongest predictors of overall survival were number of tumor arteries [relative risk (RR) 4.60 (1.96-10.78)], positive axillary lymph nodes [RR 4.48 (1.59-12.60)] and angioinvasion [RR 4.26 (1.93-9.37)]. These three parameters were also found to be independent predictors of overall survival in a multivariate analysis [RR 3.21 (1.13-9.10) for positive lymph nodes; RR 2.69 (1.33-5.41) for number of tumor arteries; RR 2.84 (1.27-6.34) for angioinvasion]. Tumor vascularisation detected by Doppler ultrasound appears to be an independent predictor of overall survival in women with early breast cancer.
Watermann
Dirk
D
Department of Obstetrics and Gynaecology, Freiburg University Medical Centre, 79106 Freiburg, Germany. watermann@frk.ukl.uni-freiburg.de
Madjar
Helmut
H
Sauerbrei
Willi
W
Hirt
Valerie
V
Prömpeler
Heinrich
H
Stickeler
Elmar
E
D000328:Adult; D001943:Breast Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000401:mortality; D011379:Prognosis; D016019:Survival Analysis; D018608:Ultrasonography, Doppler