Chalkley Microvessel but not Lymphatic Vessel DensityCorrelates with Axillary Lymph Node Metastasis in PrimaryBreast Cancers

Abstract

This study aimed to investigate tumor microvessel density (MVD) and lymphatic vessel density (LVD) usingthe Chalkley method as predictive markers for the risk of axillary lymph node metastasis and their relationshipto other clinicopathological parameters in primary breast cancer cases. Forty two node-positive and eightynode-negative breast cancers were immunostained for CD34 and D2-40. MVD and LVD were counted by theChalkley method at x400 magnification. There was a positive significant correlation of the MVD with the tumorsize, coexisting ductal carcinoma in situ (DCIS) and lymph node metastases (P<0.05). In multivariate analysis,the MVD (2.86-4: OR 5.87 95%CI 1.05-32; >4: OR 20.03 95%CI 3.47-115.55), lymphovascular invasion (OR3.46, 95% CI 1.13-10.58), and associated DCIS (OR 3.1, 95%CI 1.04-9.23) independently predicted axillarylymph node metastasis. There was no significant relationship between LVD and axillary lymph node metastasis.However, D2-40 was a good lymphatic vessel marker to enhance the detection of lymphatic invasion compared toH and E staining. In conclusion, MVD by the Chalkley method, lymphovascular invasion and associated DCIScan be additional predictive factors for axillary lymph node metastases in breast cancer. No relationship wasidentified between LVD and clinicopathological variables, including axillary lymph node metastasis.