An immunohistochemical analysis of angiogenesis in invasive breast cancer with correlations to clinicopathologic predictors

Background: There is evidence that angiogenesis plays an important role the biologic aggressiveness of breast carcinomas and might be used as a progno stic marker. Materials and Methods: In a series of 140 invasive mammary car cinomas, microvessels were highlighted immunohistochemically using two endo thelial markers, factor VIII-related antigen (FVIIIRA) and CD31. Cases were divided into high and low microvessel density groups according to the high est number of microvessels found in each tumour's most vessel-dense part. T he data was statistically analysed with regard to classic clinicopathologic prognosticators (i.e., histologic type and grade, nuclear grade, tumour si te, stage, lymph node status and steroid receptor immunoexpression) by univ ariate and multivariate analysis. Results: Both markers' counts displayed j ust a weak skewness. Interestingly, CD31 angiogenesis grade was not influen ced by any of the prognostic indicators assessed FVIIIRA immunoreactivity w as significantly affected only by nuclear grade (p = 0.041) in logistic,reg ression analysis. Infiltrating lobular carcinomas frequently demonstrated h igher FVIIIRA-positive microvessel densities than ductal invasive carcinoma s, at least in the subgroup of patients with absence of nodal metastases an d in those patients with highly oestrogen-dependent tumours. Conclusions: T he lack of relation between angiogenesis and either disease stage or lymph node metastasis indicates that this process may be necessary, but not suffi cient alone for breast cancer spread.