Microvessel Density (MVD) in Locally Advanced Breast Cancer

Background: The aim of this study was to evaluate microvessel density (MVD) by expression of CD31 and CLEC14A in core biopsies from previously untreated patients with locally advanced breast cancer (LABC) and assess its prognostic significance. Methods: MVD was evaluated in core needle biopsies (n = 92), collected prior to any treatment, from patients who were diagnosed with locally advanced breast cancer (LABC). Immunohistochemistry for expression of CD31 and CLEC14A were performed on these tumours. The median duration of follow-up was 9.3 years. The effect of prognostic factors on disease free survival (DFS) and overall survival (OS) was assessed using a Log rank test and Cox regression model. Results: The clinical factors such as age, clinical nodal stage, stage and pathological nodal status were found to be significant in predicting overall survival by multivariate analysis (P<0.05). Out of 92, 52 tumours had blood vessels expressing CD31, whereas in the remainder, there was no expression. The mean and median MVD of CD31 in 92 tumours was 38 and 5.5 respectively, and it was not a significant factor for predicting disease free survival or overall survival. When we considered the tumours (n=52) which expressed CD31, patients who had very high MVD (>100), had inferior progression free survival and overall survival (P=0.5). There was no expression of CLEC14A in any of the core needle biopsies whereas it was expressed in specimens from mastectomy from the same patient. Conclusion: This is the first report of MVD in LABC prior to any treatment. The results suggest angiogenesis could be a prognostic factor in LABC.