Microvessel Density (MVD) in Locally Advanced Breast Cancer

Abstract

Background: The aim of this study was to evaluate microvessel density (MVD) by expression of CD31 and<br />CLEC14A in core biopsies from previously untreated patients with locally advanced breast cancer (LABC) and assess<br />its prognostic significance. Methods: MVD was evaluated in core needle biopsies (n = 92), collected prior to any<br />treatment, from patients who were diagnosed with locally advanced breast cancer (LABC). Immunohistochemistry for<br />expression of CD31 and CLEC14A were performed on these tumours. The median duration of follow-up was 9.3 years.<br />The effect of prognostic factors on disease free survival (DFS) and overall survival (OS) was assessed using a Log rank<br />test and Cox regression model. Results: The clinical factors such as age, clinical nodal stage, stage and pathological<br />nodal status were found to be significant in predicting overall survival by multivariate analysis (P<0.05). Out of 92, 52<br />tumours had blood vessels expressing CD31, whereas in the remainder, there was no expression. The mean and median<br />MVD of CD31 in 92 tumours was 38 and 5.5 respectively, and it was not a significant factor for predicting disease free<br />survival or overall survival. When we considered the tumours (n=52) which expressed CD31, patients who had very<br />high MVD (>100), had inferior progression free survival and overall survival (P=0.5). There was no expression of<br />CLEC14A in any of the core needle biopsies whereas it was expressed in specimens from mastectomy from the same<br />patient. Conclusion: This is the first report of MVD in LABC prior to any treatment. The results suggest angiogenesis<br />could be a prognostic factor in LABC.