Is a histological section representative of whole tumour vascularity in breast cancer?

Abstract

Summary The assessment of a tumour's angiogenic potential, by measuring the microvessel density in histological sections, assumes that a 4-,um section is representative of whole tumour vascularity. This study has examined this assumption by comparing the vessel density found radiologically, after injecting specimens with contrast, with that found immunohistochemically. Twenty-one breast angiograms were performed following mastectomy for carcinoma and graded 1-3 for vessel density. Sections (4 jm) from these carcinomas were labelled for endothelial cells using anti-CD34, and the vessel counts were compared with the radiological grades. A significant correlation was found between the densities (P < 0.003, Kruskal-Wallis one-way ANOVA). We therefore conclude that the microvessel density measured in histological sections is representative of whole tumour vascularity.Keywords: angiogenesis; vascular heterogeneity; breast cancer; microangiography High tumour vascularity in breast cancer has been shown to correlate with poor prognosis (Bosari et al, 1992;Horak et al, 1992;Weidner et al, 1992) and has been suggested as both a useful prognostic indicator (Toi et al, 1993) and a tool for identifying those lymph node-negative breast cancer patients who might benefit from adjuvant chemotherapy (Gasparini et al, 1995). Not all studies however have found a correlation between vascularity and outcome (Van Hoef et al, 1993;Hall et al, 1992;Axelsson et al, 1995). One possible reason for this might be the sampling error inherent in the immunohistochemical technique used for microvessel density quantification. Such techniques, of necessity, look at only a tiny proportion of the tumour in a 4-gm histological section and assume that this is representative of whole tumour vascularity. Considerable heterogeneity has been found, however, within a section and between sections taken from different blocks of the same tumour (Weidner et al, 1991;Bosari et al, 1992;Van Hoef et al, 1993;De Jong et al, 1995).This study examines the relationship between vascularity, assessed by a standard immunohistochemical technique, and an estimate of whole tumour vasculature, assessed by the novel technique of breast microangiography. This allows study not only of vessel numbers but also of morphology and pattern. Using this technique, we have compared the radiological density with standard immunohistochemical data on multiple sections throughout the tumour. This new technique of vascular imaging has also clarified whether 'hot-spots' can be assessed in any part of the tumour or only at the leading edge; in addition, it has led to interesting speculation on the possible mechanisms of tumour metastasis. Received 10 September 1996Revised 29 November 1996 Accepted 16 January 1997 Correspondence to: L Martin MATERIALS AND METHODSMicroangiograms were performed on patients undergoing modified radical mastectomy for primary breast cancer at the Royal Liverpool University Hospital between October 1994 and June 1995. In theatre, immediately following removal of ...

Age and HER2 expression status affect MRI accuracy in predicting residual tumor extent after neo-adjuvant systemic treatment

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Angiogenesis is an independent prognostic factor in malignant mesothelioma

“…The detailed histopathological report was obtained for each case and the slides reviewed by a pathologist to both confirm the diagnosis and to assess the most suitable block for microvessel quantification. One block was selected and a single histological section stained, as this has been shown to be representative of tumour angiogenesis as a whole in breast cancer (Martin et al, 1997b). Cancer-specific survival was calculated from the date of the diagnostic biopsy.…”

A study on microvascular density in breast carcinoma

“…Tumor angiogenesis is generally measured by quantifying micro vessel density (MVD) in sections immune stained for vascular endothelial cell markers as CD34. [1][2][3][4][5][6][7][8][9][10][11][12][13] In normal life, angiogenesis has a vital role in reproduction, embryogenesis, menstruation, and wound healing and repair. Its importance in solid tumors was first recognized by Folkman et al in 1971, when he suggested that the continued growth of tumors was dependent on angiogenesis.…”