ASSESSMENT OF VASCULARITY IN BREAST-CARCINOMA BY COMPUTER-ASSISTED VIDEO ANALYSIS (CAVA) AND ITS ASSOCIATION WITH AXILLARY LYMPH-NODE STATUS

Case-control methodology was used to evaluate the significance of vasc ularity in small breast carcinomas with regard to the presence or abse nce of axillary lymph node metastases. Vascularity was assessed in 32 axillary node positive primary breast tumours (LN+ve) less than 2 cm i n size and compared with 56 control axillary node negative primary tum ours (LN-ve), which were matched for histological type and grade and t umour size. This study design employed computer-assisted video analysi s (CAVA) to assess the total blood vessel perimeter (BVP), total blood vessel area (BVA), and total blood vessel density (BVD) throughout a tissue section that encompassed an entire cross section of the tumour and its immediate periphery The BVA and BVD in these tumours were not significantly different between LN+ve and LN-ve groups. The LN-ve carc inomas had, on average, a significantly (P < 0.05) higher total BVP (3 355 mu m/mm(2)) than LN+ve tumours (2771 mu m/mm(2)). 'Hot spot' areas were also independently assessed by two pathologists and the same are as measured by CAVA. A strong correlation (P < 0.001) between the two methods of assessment of BVD of the neovascular 'hot spots' was found; however, no association with axillary lymph node metastasis was found using either method of assessment. In conclusion, vascularity assesse d by either blood vessel density or blood vessel size in primary invas ive breast cancers less than 2 cm in diameter showed no association wi th axillary lymph node metastasis; in fact a negative association was found with total BVP of whole tumour sections and BVD in 'hot spots' u sing CAVA. Further, this study has established a computer-assisted met hod of quantifying vascularity in solid neoplasms and is a positive st ep rewards a standardised approach to this diverse and methodologicall y variable area.