Abstract
Background: Several molecular markers have been detected that are important in clinical aspect of malignancies especially in breast cancer. More recently, the expression of vascular endothelial growth factor (VEGF), the most potent endothelial cell mitogen and also a regulator of vascular permeability, is emerging as a prognostic marker in patients with several types of cancer including breast cancer. This study assessed the expression of VEGF in a series of breast cancers in correlation with HER-2/neu and steroid receptors (ER and PR) in standard clinicopathological parameters in an attempt to clarify its potential clinical importance in Iraqi females of Middle Euphrates area. Findings: The present investigation was performed over a period starting from September 2011 through September 2012. Formalin-fixed, paraffin-embedded blocks from 52 patients with breast cancer (44 ductal and 8 lobular carcinoma) were included in this study. A group of 20 patients with fibroadenoma was included as a comparative group, and 20 samples of normal breast tissue sections were used as controls. Labeled streptavidin-biotin (LSAB+) complex method was employed for immunohistochemical detection of VEGF, HER-2/neu, ER and PR. The detection rate of VEGF, HER-2/neu, ER and PR was 59.62%, 36.96%, 34.62% and 36.54% respectively. There was a significant difference in immunoexpression between ductal and lobular carcinoma, but not significantly different among tumor sizes, tumor grades, axillary lymph node involvement and age of the patients. However, VEGF was positively correlated with tumor grade, tumor size, nodal involvement and HER-2/neu, but negatively correlated with ER and PR, which show the most unfavorable biopathological profile. Conclusion: VEGF overexpression play an important role in pathogenesis of breast carcinoma evolution, as its positivity associated with biologically aggressive tumors, so incorporation of this biomarker with other parameters into a prognostic index will more accurately predict clinical outcome and determine the effects of anti cancer therapy.
Highlights
Breast carcinoma is one of the most important diseases for women and constitutes about one fourth of all cancers, making it the most common cancer in females [1]
vascular endothelial growth factor (VEGF) was positively correlated with tumor grade (0% for grade I, 50% grade II, 65.79% grade III), tumor size if excluding in situ component, with positive nodal involvement (Table 5), with HER-2/neu (14 out of 17 HER2 positive cases were VEGF positive while 14 out of 29 HER2 negative cases were VEGF positive) (Table 6), but negatively correlated with estrogen receptor (ER) and progesterone receptor (PR), as explained: (8 out of 18 ER positive cases were VEGF positive while 23 out of 34 ER negative cases were VEGF positive) (Table 7), (10 out of 19 PR positive cases were VEGF positive while 21 out of 33 PR negative cases were VEGF positive) without a significant difference (P > 0.05) and these show the most unfavorable biopathological profile
The results of this study revealed that there was no significant difference in VEGF immunoexpression among different age groups, this may be corresponding to the natural frequency of breast cancer
Summary
Breast carcinoma is one of the most important diseases for women and constitutes about one fourth of all cancers, making it the most common cancer in females [1]. The expression of vascular endothelial growth factor (VEGF), the most potent endothelial cell mitogen and a regulator of vascular permeability, is emerging as a prognostic marker in patients with several types of cancer including breast cancer. This study assessed the expression of VEGF in a series of breast cancers in correlation with HER-2/neu and steroid receptors (ER and PR) in standard clinicopathological parameters in an attempt to clarify its potential clinical importance in Iraqi females of Middle Euphrates area. Conclusion: VEGF overexpression play an important role in pathogenesis of breast carcinoma evolution, as its positivity associated with biologically aggressive tumors, so incorporation of this biomarker with other parameters into a prognostic index will more accurately predict clinical outcome and determine the effects of anti cancer therapy
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