Abstract
Abstract Background) Breast cancer is a leading cause of death worldwide. Tumor vascularity is a hallmark of cancer including breast cancer. However, targeting tumor vascularity did not show consistent benefit when applied in clinic. This study aimed to investigate in which group of patients can tumor vascularity be a prognostic factor and how does change of tumor vascularity play in this situation. Materials and methods) Female patients with breast cancer who received preoperative chemotherapy due to breast cancer between 2003 and 2018 at Wonju Severance Hospital, Korea, were included. Clinocopathological characteristics were collected. Hounsfield units(HU) on contrast-enhanced computed tomography(CT) was used as a marker indicating tumor vascularity. Tumor to aortic arch ratio(TAR) of HU on contrast enhanced CT was applied to enhance objectivity of measurement. Patients were categorized according to the cut-off values retrieved from the receiver operating characteristic curve. Kaplan-Meier curves were generated to compare recurrence-free interval (RFI) and overall survival (OS). Results) The final cohort included 162 patients with a mean age of 48.63±7.9 (30-69) years. Initial TAR was 0.38±0.103 (range, 0.184-0.946) and TAR after completion of preoperative systemic treatment was 0.29 0.094(0.677-0.298). Difference between TAR of immediate before surgery and first clinical presentation was -0.0860.094(-0.386 – 0.176). TAR was decreased in 122 (75.3%) patients. Initial TAR was significantly correlated with recurrence free survival(RFS)(p=0.002). However, TAR after preoperative systemic treatment (p=0.221) or delta TAR (area under receiver operating characteristics = 0.498) were not significant. Interestingly, initial TAR was significant only in patients with decreased TAR after preoperative systemic treatment(p=0.005). Conclusion) Tumor vascularity represented with HU was significantly related with patients’ survival only when tumor vascularity was decreased in response to systemic treatment. Considering no antiangiogenic agents were applied as preoperative systemic treatment and still capacity of tumor vascularity as a biomarker was influenced by the change of itself, antiangiogenic agents could be used as a complimentary agent for the other agents which also impact tumor vascularity. Citation Format: Hyang Suk Choi, Eun Ju Son, Hany Hany Noh, In-Jeong Cho In-Jeong Cho, Seung Taek Lim, Jong-In Lee, Airi Han. Performance of tumor vascularity as a biomarker is correlated with the change of tumor vascularity after preoperative systemic treatment in patients with breast cancer. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-11-30.
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