Prognostic Significance of Tumor Angiogenesis in Breast Cancer / 한국유방암학회지

The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The development of other accurate prognostic factors would help in assessing high risk for recurrence and death. Recently, much experimental evidence has accumulated showing that tumor growth and metastasis are dependent on tumor angiogenesis. To investigate the status of angiogenesis in breast cancer, we counted the microvessel density (MVD) of brest cancer tissues, which were stained with anti-CD34 antibody, as a measure of tumor angiogenesis. We classified 43 breast-cancer patients into 22 with low MVD ( or =47/200xPF). We estimated the correlations between the MVD and other established prognostic factors. We also calculated survivals based on MVD. The MVD was in the range between 10 and 93 (mean+/-SD=46.9+/-21.7). The positive rate of lymph-node metastasis in high MVD patients was 32.6%, which was higher than the 23.3% for low-MVD patients. We found a significant correlation between MVD and histologic grade (p=0.037), but could not fine any significant correlation between MVD and menopausal status, tumor size, nuclear grade, estrogen receptor, or progesterone receptor. Retrospectively, the receptor status of estrogen and of progesterone had significant impacts on survival (ER: p=0.0001, PR: p=0.0001). The 4-year disease-free survival rate of high-MVD patients was 56.6+/-12.5%, and that of low-MVD patients was 69.0+/-10.8% (p=0.449). The 4-years overall survival rate of high-MVD patients was 71.1+/-11.1%, and that of low-MVD patients was 74.1+/-12.2 (p=0.449). In conclusion, the determination of MVD in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the MVD in a large number of patients before this conclusion can be stated with certainty.

Prognostic Significance of Tumor Angiogenesis in Breast Cancer

The well-known prognostic factors for breast cancer, such as axillary lymph node status, do not always account for the exact outcome. The development of other accurate prognostic factors would help in assessing high risk for recurrence and death. Recently, much experimental evidence has accumulated showing that tumor growth and metastasis are dependent on tumor angiogenesis. To investigate the status of angiogenesis in breast cancer, we counted the microvessel density(MVD) of breast cancer tissues, which were stained with anti-CD34 antibody, as a measure of tumor angiogenesis. We classified 43 breast-cancer patients into 22 with low MVD ( or =47/200 PF). We estimated the correlations between the MVD and other established prognostic factors. We also calculated survivals based on MVD. The MVD was in the range between 10 and 93(mean SD=46.9 21.7). The positive rate of lymph-node metastasis in high-MVD patients was 32.6%, which was higher than the 23.3% for low- MVD patients. We found a significant correlation between MVD and histologic grade (p=0.037), but could not find any significant correlation between MVD and menopausal status, tumor size, nuclear grade, estrogen receptor, or progesterone receptor. Retrospectively, the receptor status of estrogen and of progesterone had significant impacts on survival (ER : p=0.0001, PR : p=0.0001). The 4-year disease-free survival rate of high-MVD patients was 56.6 12.5%, and that of low-MVD patients was 69.0 10.8% (p=0.449). The 4-year overall survival rate of high-MVD patients was 71.1 11.1%, and that of low-MVD patients was 74.1 12.2 (p=0.449). In conclusion, the determination of MVD in breast cancer tissue may be useful as a prognostic factor, but it is necessary to investigate the MVD in a large number of patients before this conclusion can be stated with certainty.

Clinical Analysis and Prognostic Significance of Menopausal Status in Breast Cancer

The influence of age and menopausal status at diagnosis on the prognosis of patients with primary breast cancer remains controversial. Some studies have found that younger patients have worse clinical outcomes than older patients, others have reported that younger patients have a more favorable outcome, and others have found no relation with age. We analyzed the effects of menopausal status in the survival of patients with operable breast cancer and estimated the correlations between the menopausal status and other established prognostic factors. We reviewed the records of the patients who had been operated on at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University during the past 10 years (1985~1996). The results were as follows: 1) The peak age group was the fifth decade (27%), and all of patients, except one, were females. 2) The most common symptom was a palpable breast mass with or without pain (88%). 3) Most patients (72.8%) visited within 6 months of the first appearance of a symptom, and the most frequent tumor size was 2~5 cm in diameter (58.9%). 4) Most of the primary tumors were located in the upper outer quadrant (61%); tumors located in the lower outer quadrant were rare (3%). 5) The most common TNM stage group was stage II (54.1%), and there was no difference of distribution between the premenopause and the postmenopause groups. 6) The common pathologic cancer types were infiltrating ductal cancer (73.8%), medullary cancer (9.3%), mucinous cancer (8.3%). 7) Axillary lymph-node metastasis was present in 58 cases (62.4%). 8) The overall five-year survival rate for all patients was 43.9%. 9) The five-year survival rates of the 38 premenopausal patients and the 38 postmenopausal patients were 42.4% and 35.8%, respectively, but there was no statically significant difference between the two groups. 10) Menopausal status did not significantly correlated with tumor size, tumor location, lymph-node metastasis or TNM stage. In conclusion, the menopausal status may be not correlated with the prognosis in breast cancer However, the effect of menopausal status on the prognosis of patients with breast cancer needs to be investigated for a large papulation of breast cancer patients.

Rupture of Femoral Artery by External Fixator

The authors report a case of superficial femoral arterial trauma caused by external fixator in 53 year-old male patient who had supracondylar fracture of femur due to automobile accident. After removal of external fixator, autogenous bypass graft was perfomed with reversed great saphenous vein. The occlusion of the graft occurred 3 months later, we thought that interposition graft in the chronic inflammatory and fibrotic tissue should be avoided.