Microvessel density and vessel invasion in lymph‐node‐negative breast cancer: Effect on recurrence‐free survival

Abstract

Microvessel density (MVD) and blood and lymphatic vessel invasion (BLVI) were investigated with regard to their influence on the disease - free survival (DFS) in node - negative breast cancer patients. Paraffin embedded microsections of 230 patients with T1,2 NO breast cancer were immunohistochemically stained for factor Vlll - related antigen. Every cluster consisting of more than highlighted endothelial cells was considered a countable microvessel. MVD was counted in 4 fields of 0.25 mm² each. All MVD values are given as value for the sum of 4 fields of 0.25 mm² each, that is, I mm². BLVI was considered positive, when at least one tumor cell could be identified in a stained lumen. Out of 230 patients, 49 experienced local or distant recurrence and had a mean MVD of 72.4/mm², whereas 181 patients who lived without recurrent disease had a mean MVD of 45.3/mm². BLVI was negative in 6.2% of the cases with and in 93.8% of the cases without recurrent disease. BLVI was positive in 59.4% of the cases without and 40.6% of the cases with recurrent disease. MVD and BLVI remained the only significant prognostic factors of DFS in the Cox - Model. Tumor size, histological grade, and hormonal - receptor status were not prognosticallv relevant in the Cox - model. 10 - year - DFS was 93.3% in BLVI - negative/MVD ⩽ 40/mm² patients, 88.1% when MVD was high or BLVI was positive and 48.9% in BLVI positive/MVD ⩽ 40/mm² patients. Our present data indicate that MVD and BLVI identify a very - low risk group among node - negative breast cancer patients, who will not benefit from systemic adjuvant therapy. MVD and BLVI should be used as stratification criteria in clinical trails on node - negative breast cancer patients. © 1995 Wiley-Liss Inc.