Assessment of endothelial cell proliferation in primary breast carcinoma and its association with axillary lymph node status

Abstract

The correlation between angiogenesis as assessed by endothelial cell proliferation in blood/lymphatic vessels in primary breast carcinomas, and axillary lymph-node metastasis was studied using a case-control design. Primary breast carcinomas, ⪢ 2 cm in diameter, from 26 axillary node positive patients (case), were compared with neoplasms from 45 node-negative patients (control). Vascularity, as assessed by vessel density, and endothelial cell proliferation were measured in a single tissue section using a double immunohistochemical staining technique using MIBI (Ki-67) and FVIII antibodies. No association between vascularity and node status was found (P⪢ 0.70). Node positive breast carcinomas had, on average, significantly smaller proliferating vessels (140±7μm in perimeter) in the primary lesion when compared with node negative tumours (164±7μm in perimeter (P⪢0.02). In addition, the frequency of relatively small vessels (less than 180 μm in perimeter) with proliferating endothelium was higher in node positive carcinomas than lymph-node negative neoplasms (P⪢0.03). This association between node status and the size and frequency of blood/lymphatic vessels with proliferating endothelium in primary carcinoma may have important implications in metastasis.