Abstract
Abstract Background: The angiogenic status of a tumor is related to the prognosis of the patient, and to the possibility of treatment with angiogenesis inhibitors. Patients who express telangiectasias (spiders) in the skin have an increased ability to form vessels, due to, for example, hormonal influences. We hypothesized that tumor tissue to some extent resembles the normal tissue in a patient, which could mean that is if a patient is prone to form spiders in the skin, the same would be true in their tumors. Spiders are associated with hormonal influence, and therefore telangiectasias in patients could be a reflection of hormonal influence and angiogenic status of their tumor. Materials and methods: A clinical series of 1682 consecutive breast cancer patients diagnosed between 1980 and June 2009 were studied. One physician scored the presence/absence of spiders on the upper part of the body at the time of breast cancer diagnosis. The aim was to further study the association between telangiectasias and classical histopathologic subtypes of breast cancer, HRT-ever use, life time number of menstrual cycles and ever use of oral contraceptive pills (OCP). All analyses were performed using multivariate logistic regression, a confidence interval (CI) of 95% was used. Results: The occurrence of telangiectasias of the upper thorax, neck and face was positively associated with HRT-ever use (OR = 3.24 (CI 2.02 – 5.19)), OCP-ever use (OR = 2.08 (CI 1.30 – 3.32)) and high number of menstrual cycles, above 550 – the upper quartile OR = 4.57 (CI 1.49-13.95). Weight was also associated with spiders, p = 0.006. Contrary to the other histopathologic subtypes no telangiectasias in the skin were observed in patients with comedo carcinoma, p = 0.0002 (Fisher's exact test). No significant difference in spiders was seen between the other patients with the other subtypes. The results above were adjusted for age at diagnosis and for each studied variable simultaneously. Conclusion: The occurrence of spiders was associated with several hormonal factors indicating the importance of hormones in the induction of telangiectasias. Our theory that the tendency to form vessels is similar in normal tissue as well as in tumor tissue could explain the necrotic core in comedo carcinoma. It has been hypothesized that the necrotic core is due to the high growth rate of the tumor, but it might be due to a lesser ability to form vessels. Are comedo carcinoma patients a group who benefit less from anti-angiogenic therapy while patients with strong endogenous or exogenous hormonal exposures would benefit more from anti-angiogenic therapy? Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3727. doi:10.1158/1538-7445.AM2011-3727
Published Version
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