Vascular proliferation is a prognostic factor in breast cancer

Breast Cancer Res Treat. 2012 Jun;133(2):501-10. doi: 10.1007/s10549-011-1785-7. Epub 2011 Sep 27.


Angiogenesis is important for the growth and spread of malignant tumors, and anti-angiogenesis treatment is currently being evaluated for breast cancer and other tumors. Although microvessel density is the most commonly used tissue-based marker of tumor associated angiogenesis, it has significant limitations and has not proven effective as a predictive factor in selecting patients for treatment. We here wanted to explore the significance of vascular endothelial cell proliferation in breast carcinoma. We examined microvessel proliferation in breast cancer by dual immunohistochemical staining, using the pan-endothelial marker Factor-VIII combined with proliferation of endothelial cells by Ki-67 expression, in three independent series of breast cancer, including a total of 499 patients and 141 events during follow-up. Common statistical tests of associations as well as univariate and multivariate regression analysis of patient survival were used. By counting vessels with actively proliferating endothelium, we show that microvascular proliferation is a significant predictor of disease progression in breast cancer, especially among high-grade and ER-negative tumors. Our findings indicate that this novel marker of active tumor angiogenesis might be of value in patient management and should be further studied in the context of patient selection for anti-angiogenesis treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / blood supply*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Endothelial Cells / metabolism
  • Female
  • Humans
  • Microvessels
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Neovascularization, Pathologic*
  • Prognosis
  • Survival Analysis