Expression of VEGF-C in Breast Carcinoma and its Association with HER2/neu and Oestrogen/ Progesterone Receptors: A Cross-sectional Study

Abstract

Introduction: Breast carcinoma is the most common malignant tumour and is the leading cause of carcinoma death in women. Assessing Vascular Endothelial Growth Factor-C (VEGF-C) is important because the expression of VEGF-C is one of the factors determining the aggressiveness of breast carcinoma. Aim: To evaluate the expression of VEGF-C in breast carcinoma and its association with HER2/neu and Oestrogen Receptors (ER)/Progesterone Receptors (PR). Materials and Methods: A cross-sectional observational study was carried out in Department of Pathology of a tertiary care center of Burdwan Medical College and Hospital, West Bengal from 1st January 2018 to 30th June 2019. Patients attending Outpatient Department (OPD) and were diagnosed clinically as having breast cancer, operated upon, and subsequently sent for Histopathological Examination (HPE) in Pathology. The samples which were positive for breast carcinoma by histopathology were further studied with Immunohistochemical (IHC) markers and the positivity of IHC expression was reported using standard procedure and scoring pattern. The assosciation of VEGF-C expression with respect to histological type, grade, and stage of cancer as well as the HER2/neu and ER/PR status was studied. Using the Statistical Package for Social Sciences (SPSS) version 18.0, Chi-square was applied for the significance of p-value and the significance level was considered at a p-value <0.05. Results: This study consisted of 44 cases of malignant breast lesions and of which 27 cases were associated with axillary lymph nodes. After IHC staining, 25 (56.82%) were VEGF-C positive and the rest 19 (43.18%) were VEGF-C negative. There was a significant association between VEGF-C and histologic grades of breast carcinoma. VEGF-C expression was significantly associated with lymph node metastasis and with HER2/neu. VEGF-C seems to be significantly associated with ER status of breast carcinoma and was not associated with the PR status of breast carcinoma. Conclusion: Assessment of VEGF-C is recommended because expression of VEGF-C is one of the factors determining the aggressiveness of breast carcinoma. If VEGF-C is positive in node- negative breast carcinoma, then it may help in targeted therapy of breast carcinoma before lymphatic metastasis develops.