VASCULARITY DEMONSTRATED BY DOPPLER ULTRASOUND AND IMMUNOHISTOCHEMISTRY IN INVASIVE DUCTAL CARCINOMA OF THE BREAST

Background: Vascularity is an important determinant of a tumour's abil ity to grow and disseminate. Breast tumour vascularity can be determin ed with doppler ultrasound (US) and by counting the vessels microscopi cally (microvascular density - MVD). The biologic characteristics of t umours based on their vascularity have not been extensively studied. M ethod: Preoperative US was performed on 207 patients with invasive duc tal breast carcinomas (IDC). MVD was assessed immunohistochemically us ing polyclonal antisera against factor VIII and the proliferation rate was measured with Ki-67 polyclonal antisera. Histologic tumour charac teristics and oestrogen receptor (ER) status were determined. Thermogr aphy was performed on 174 of the patients, Results: Twenty-five percen t of IDC demonstrated US-vascularity. US-vascular tumours were more li kely to be node positive, and had a higher mitotic rate than avascular cancers. US-vascularity was more common in tumours with MVD greater t han 80 vessels/250x field than those with fewer vessels. The prolifera tion rate, histologic grade III, and nuclear grade III were higher and ER positivity lower, but the differences were not statistically signi ficant. US-vascular cancers were associated with significantly more th ermographic abnormalities. The cancer recurrence rate at three years w as higher in patients with vascular cancers although the difference wa s not statistically significant. Conclusion: US appears to be a simple , non-invasive method of identifying vascular cancers associated with factors indicating a poor prognosis.