Long term outcome of small size invasive breast carcinomas independent from angiogenesis in a series of 685 cases.

BACKGROUND To document the role of neoangiogenesis in the progression of breast carcinomas, intratumoral vascular density (ITVD) was assessed and com pared to pathologic data and disease outcome in a series of 685 cases. METHODS, Patients were registered between 1981 and 1988 at the Curie Institute. Tumors corresponded to small size (less than or equal to 30 mm) invasive carcinomas, 71% of which were axillary lymph node negative. In all cases, conservative surgery was the initial therapeutic procedure. The median follow-up was 10.8 years. ITVD was retrospectively determined as the number of immunostained (anti-F8RA/vWF antibody) vessels in an area of 1.2 mm(2). The prognostic value of ITVD regarding overall survival, locoregional recurrence-free, and metastasis-free intervals was assessed in uni- and multivariate analyses. RESULTS. Microvessel count ranged from 5-245 per 1.2 mm2 field. The median value was 62, and the mean was 67. The median was chosen as a cut point for statistical analysis. ITVD was found to be inversely linked to tumor size (P less than or equal to 0.0001) and histologic grade (P = 0.005), and directly linked to vascular invasion (P = 0.02). In uni- and multivariate analysis, no significant link was found between ITVD and disease outcome, even after adjustment on histologic grade and tumor size. CONCLUSIONS. ITVD was inversely correlated to tumor size and histologic grade in our series of small-size breast carcinomas. No significant link between ITVD and disease outcome was observed. Evaluation of the role of angiogenesis in tumor progression should be based on the discriminative assessment of mature and/or activated vessels. (C) 2001 American Cancer Society.