title: Absence of lymphangiogenesis in ductal breast cancer at the primary tumor site.
abstract: Solid evidence for a relationship between lymphangiogenesis and prognosis in human breast cancer is still lacking. Evidence for ongoing lymphangiogenesis in breast cancer is only provided by animal studies. In the present study we investigated lymphatic vessel density as well as the expression level of the lymphangiogenic factors VEGF-C and -D in a series of 121 ductal breast cancer tissues using immunohistochemical stainings. We found that in the primary tumors the lymphatic vessel density, as well as the expression of both VEGF-C and -D, did not relate to grade, tumor stage, progression or patient survival. Furthermore, in tumors in which lymphatic vessels were present, a Ki-67/podoplanin double staining indicated the absence of proliferating lymphatic endothelial cells. In contrast, we did find a correlation between intratumoral lymphatic vessel density inside the lymph node metastases and patient survival. Another parameter that revealed prognostic value was the presence of tumor cells within the lymphatic vessels. This parameter did predict survival in patients with an age below 63 only. Interestingly, expression of VEGF-D was found to be related to the presence of intralymphatic tumor cells.
authors: Angiogenesis Laboratory, Department of Pathology, Maastricht University and Hospital, Maastricht, The Netherlands.
authors: Daisy W J
authors: DW
authors: van der Schaft
authors: Patrick
authors: P
authors: Pauwels
authors: Sarah
authors: S
authors: Hulsmans
authors: Miriam
authors: M
authors: Zimmermann
authors: Lonneke V
authors: LV
authors: van de Poll-Franse
authors: Arjan W
authors: AW
authors: Griffioen
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000032:analysis; D042583:Lymphangiogenesis; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology*; D008562:Membrane Glycoproteins / Q000032:analysis; D008875:Middle Aged; D011379:Prognosis; D042582:Vascular Endothelial Growth Factor C / Q000032:analysis; D042643:Vascular Endothelial Growth Factor D / Q000032:analysis; D000098853:Podoplanin
chemical_list: D019394:Ki-67 Antigen; D008562:Membrane Glycoproteins; D042582:Vascular Endothelial Growth Factor C; D042643:Vascular Endothelial Growth Factor D; C117468:PDPN protein, human; D000098853:Podoplanin