Vascular density as a prognostic indicator for invasive ductal breast carcinoma

Estimated vascular density obtained with the aid of antibodies against endothelial cells has been claimed to be an independent prognostic indicator for invasive ductal breast carcinoma. Since 1991 most studies have counted the number of vessels with the optic microscope. We have performed immunohistochemical staining for Factor VIII on formaldehyde-fixed, paraffin-embedded primary invasive ductal carcinomas from 112 patients, with a minimal follow-up time of 60 months, who had received postoperative chemoradiation therapy. We have performed a manual count with a 20x objective of the vessels in the vascular hot-spot identified in a 4x field. We analysed the association of this factor with epidemiological risk factors, histopathological features, hormonal receptor status and p53 and c-erbB-2 expression and the influence on prognosis. In univariate analysis vascular density is a significant prognostic indicator in both node-negative and node-positive patients, together with staging, Baak's morphometric multiparametric index, tumour size and histological grade. However, in multivariate analysis only tumour staging and vascular density are independent prognostic factors in breast carcinoma.