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Reduction in angiogenesis after neoadjuvant chemoendocrine therapy in patients with operable breast carcinoma
A Makris1, T J Powles, S Kakolyris
1Breast Unit, Royal Marsden Hospital, Sutton, Surrey, United Kingdom.
Background:
The intensity of angiogenesis, as measured by microvessel density, is a strong independent predictor of survival in breast carcinoma patients. The impact of chemotherapy and/or endocrine therapy on this process is unknown.
Methods:
Histologic samples from patients randomized to a trial of neoadjuvant (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 monoclonal antibody and the scoring of microvessels was performed using the Chalkley method.
Results:
The median score of the NEO patients was 5.7 (95% confidence interval [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 > or =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 chemoendocrine therapy causes a reduction in microvessel density in primary breast carcinomas, which could be secondary to tumor regression or due to a direct effect on angiogenesis.