Vascular Endothelial Growth Factor-A (VEGF-A) as a Prognostic Marker in Cases of Carcinoma Breast

Abstract

Background: Angiogenesis is a necessary step in the growth of any tumour and metastasis. Vascular endothelial growth factor (VEGF) is a major mediator of breast cancer angiogenesis. The expression of VEGF by breast tumours has been previously correlated with a poor prognosis in the pathogenesis of breast cancer. Method: In this cross-sectional descriptive study 54 women were enrolled over the period of 2 years. This study was aimed to determine the correlation between serum and tissue levels of VEGF-A and prognosis in carcinoma of breast cases. It also tried to correlate the aggressiveness of the disease with serum and tissue levels of VEGF-A in the subject population. Results: In benign cases, preoperative serum VEGF-A (sVEGF-A) levels remained within 3000 pg/ml while post-operative sVEGF-A levels never went beyond 2300pg/ml. In the majority of carcinoma breast cases, preoperative sVEGF-A levels remain within 4000 pg/ml while post-operative sVEGF-A levels never went beyond 3000pg/ml. All the benign lesions were negative for tissue VEGF-A (tVEGF-A). While all malignant lesions were positive for tVEGF-A in the immunohistochemistry (IHC) study. Patients with a malignant lesion of higher tumour grades were having high tVEGF-A readings (2+ or more). In this study higher nodal status was associated with higher tVEGF-A reading. Similarly, tVEGF-A was higher in ER/PR/Her2neu negative cases. Conclusions: Determination of VEGF-A can be considered a promising, but investigative and prognostic tool. Large prospective studies are necessary to better define the relationship of prognosis to angiogenesis and VEGF-A.