title: Breast carcinoma vascularity: a comparison of manual microvessel count and Chalkley count.
abstract: Manual counting of microvessels as intratumoral microvessel density (MVD) and Chalkley counting have been used in several studies to assess the prognostic impact of vascularity in invasive breast carcinomas. In our present study, the aim was to evaluate the prognostic value of angiogenesis in invasive breast carcinoma assessed by MVD and Chalkley techniques in the same series of patients. A total of 498 breast carcinoma patients with median follow up time 85 months were evaluated. The tumour vascularity was quantified by both manual microvessel count (MVD) and Chalkley count in CD34 stained breast carcinoma slides by a single investigator blinded to clinical information. Other relevant clinicopathological parameters were noted, including breast cancer related death and both loco-regional and systemic relapse. The patients were stratified by converting MVD and Chalkley counts to categorical variables to assess prognostic impact, and results were compared. High vascular grades using MVD count did not demonstrate any prognostic significance for breast cancer specific survival (BCSS) or distant disease free survival (DDFS) either in whole patient group (BCSS, p=0.517, DDFS, p=0.301) or in non-treated node negative patients (p>0.05). Chalkley count showed prognostic significance for both DDFS and BCSS in whole patient group (p<0.001) and also in untreated node negative patient group (p<0.05). In multivariate analysis, Chalkley count, but not MVD, retained the prognostic value for BCSS (p=0.007) and DDFS (p=0.014). The Chalkley count for assessing angiogenesis in invasive breast carcinomas demonstrated prognostic value. The Chalkley method appears to be the better method in estimating the prognostic impact of vascularity in invasive breast carcinomas.
authors: Division of Pathology, The Norwegian Radium Hospital, Rikshospitalet University Hospital, Faculty Division The Norwegian Radium Hospital, Medical Faculty University of Oslo, Montebello, Oslo, Norway. Hari.Prasad.Dhakal@radiumhospitalet.no
authors: Hari Prasad
authors: HP
authors: Dhakal
authors: Assia
authors: A
authors: Bassarova
authors: Bjørn
authors: B
authors: Naume
authors: Marit
authors: M
authors: Synnestvedt
authors: Elin
authors: E
authors: Borgen
authors: Rolf
authors: R
authors: Kaaresen
authors: Ellen
authors: E
authors: Schlichting
authors: Gro
authors: G
authors: Wiedswang
authors: Karl-Erik
authors: KE
authors: Giercksky
authors: Jahn M
authors: JM
authors: Nesland
mesh_terms: D001808:Blood Vessels / Q000473:pathology*; D001943:Breast Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018275:Carcinoma, Lobular / Q000098:blood supply* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009389:Neovascularization, Pathologic / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors