Reduction in angiogenesis after neoadjuvant chemoendocrine therapy in patients with operable breast carcinoma

BACKGROUND. The intensity of angiogenesis, as measured by microvessel densi ty, is a strong independent predictor of survival in breast carcinoma patie nts. The impact of chemotherapy and/or endocrine therapy on this process is unknown. METHODS. Histologic samples from patients randomized to a trial of neoadjuv ant (NEO) versus adjuvant (ADJ) chemoendocrine therapy for operable breast carcinoma were obtained. Samples from 195 patients (90 NEO samples and 105 ADJ samples) were analyzed. Immunostaining was performed with the CD34 mono clonal antibody and the scoring of microvessels was performed using the Cha lkley method. RESULTS, The median score of the NEO patients was 5.7 (95% confidence inter val [CI], 5.3-6.0) and the median score of the ADJ patients was 6.3 (95% CI , 6-6.7) (P = 0.025). Using previously validated scoring categories, there were fewer samples with a poor prognosis (score greater than or equal to 7) in the NEO group (26%) compared with the ADJ group (32%) (P = 0.04). CONCLUSIONS. The results of the current study suggest that NEO chemoendocri ne therapy causes a reduction in microvessel density in primary breast carc inomas, which could be secondary to tumor regression or due to a direct eff ect on angiogenesis. (C) 1999 American Cancer Society.