Assessment of tumor angiogenesis in invasive breast carcinomas: absence ofcorrelation with prognosis and pathological factors

Different retrospective studies have shown that microvessel counting (MVC) is an independent prognostic marker for clinical outcome in breast cancer. The aim of this study was to evaluate the prognostic value of MVC alone or in association with classical clinicopathological parameters, as well as th e reproducibility of the technique. We analyzed a retrospective series of 2 16 cases of breast carcinoma. Tissue sections were stained for Factor-VIII- related antigen. Microvessel quantification was performed at x400 magnifica tion in the three most vascular areas of the tumors (hot spots). Mean and h ighest values were studied. Furthermore, a semi-quantitative evaluation of MVC was performed by use of an image-analysis system. The effect of multipl e factors on survival was tested under a Cox multivariate proportional haza rds model. In ten cases, a study of the reproducibility was done by evaluat ing MVC in different sections of the same block and in different blocks of a same tumor. There was no association between MVC (determined at a microsc opic level or by image analysis) and overall survival or relapse-free survi val. No association was found with tumor size, tumor grade, and lymph-node status. The study of reproducibility showed a very high intra-tumoral varia tion of MVC. The intra-individual coefficient of variation (CV) varied betw een 20 and 80%. This study did not show any significant correlation between angiogenesis, as assessed by MVC, and relapse-free survival or overall sur vival in infiltrating breast carcinomas. The low reproducibility of the MVC for the same tumors suggests that this technique must still be optimized b efore routine application.