Vascularity demonstrated by Doppler ultrasound and immunohistochemistry in invasive ductal carcinoma of the breast.

BACKGROUND

Vascularity is an important determinant of a tumour's ability to grow and disseminate. Breast tumour vascularity can be determined with doppler ultrasound (US) and by counting the vessels microscopically (microvascular density-MVD). The biologic characteristics of tumours based on their vascularity have not been extensively studied.

METHOD

Preoperative US was performed on 207 patients with invasive ductal breast carcinomas (IDC). MVD was assessed immunohistochemically using polyclonal antisera against factor VIII and the proliferation rate was measured with Ki-67 polyclonal antisera. Histologic tumour characteristics and oestrogen receptor (ER) status were determined. Thermography was performed on 174 of the patients.

RESULTS

Twenty-five percent of IDC demonstrated US-vascularity. US-vascular tumours were more likely to be node positive, and had a higher mitotic rate than avascular cancers. US-vascularity was more common in tumours with MVD greater than 80 vessels/250x field than those with fewer vessels. The proliferation rate, histologic grade III, and nuclear grade III were higher and ER positivity lower, but the differences were not statistically significant. US-vascular cancers were associated with significantly more thermographic abnormalities. The cancer recurrence rate at three years was higher in patients with vascular cancers although the difference was not statistically significant.

CONCLUSION

US appears to be a simple, non-invasive method of identifying vascular cancers associated with factors indicating a poor prognosis.