VASCULAR ENDOTHELIAL GROWTH-FACTOR IN PREMENOPAUSAL WOMEN - INDICATOROF THE BEST TIME FOR BREAST-CANCER SURGERY

Timing of surgery in premenopausal patients with breast cancer remains controversial. Angiogenesis is essential for tumour growth and vascul ar endothelial growth factor (VEGF) is one of the most potent angiogen ic cytokines. We aimed to determine whether the study of VEGF in relat ion to the menstrual cycle could help further the understanding of thi s issue of surgical intervention. Fourteen premenopausal women were re cruited, along with three post-menopausal women, a woman on an oral co ntraceptive pill and a single male subject. Between eight and 11 sampl es were taken per person, over one menstrual cycle (over 1 month in th e five controls) and analysed for sex hormones and VEGF165. Serum VEGF was significantly lower in the luteal phase and showed a significant negative correlation with progesterone in all 14 premenopausal women. No inter-sample variations of VEGF were noted in the controls. Serum f rom both phases of the cycle from one subject was added to MCF-7 breas t cancer cells; VEGF expression in the supernatant was lower in the ce lls to which the luteal phase serum was added. The lowering of a poten t angiogenic cytokine in the luteal phase suggests a possible decrease d potential for micrometastasis establishment in that phase. This fall in VEGF may be an effect of progesterone and should be the focus of f uture studies.