Prognostic Value of Apoptosis in Breast Cancer

The aim of this study was to determine if the apoptotic degree could predict the prognosis for breast cancer in mastectomy specimens and to establish if any association existed between the apoptotic degree and clinical variables such as age, size, hormone receptor, lymph node metastasis, stage, result of follow up. The apoptotic degree, defined as the number of morphologically identified apoptotic bodies in the view of a 200X microscope, was calculated for 59 breast cancers. We applied an immunohistochemical procedure for staining the apoptotic cells in parapin sections of 59 breast cancers. The histochemical method used for the analysis of apoptosis was based on the detection of DNA breaks by terminal transferase-mediated in situ end labeling (TUNEL). The results were as follows; 1. An association between apoptotic degree and age was demonstrable (p=0.050). 2. No association between apoptotic degree and tumor size was demonstrable. 3. No association between apoptotic degree and lymph node metastasis was demonstrable. 4. An association between apoptotic degree and stage was demonstrable. 5. No association between apoptotic degree and hormone receptor was demonstrable (p=0.023). 6. No association between apoptotic degree and follow up results was demonstrable, however a low apoptotic degree showed a tendency for a poor clinical outcome, and this result had partiall statistical significance. Thus provisionally its value as an independent prognostic index has yet to be established and demands more study.

Prognostic Value of Angiogenesis in Breast Cancer

BACKGROUND: There is considerable experimental evidence to indicate that tumor growth is dependent on angiogenesis. To investigate how tumor angiogenesis correlates with clinical factors and prognosis in breast carcinoma, we counted microvessels (capillaries and venules) and graded the density of micro vessels within the invasive ductal carcinomas of 59 patients. METHODS: Using light microscopy, we highlighted the vessels by staining their endothelial cells immu nohistochemically for rabbit antihuman factor-VIII related antigen (Dako L1809, USA). The microvessels were carefully counted (per 200 field) in the most active areas of neovascularization without knowledge of either the outcome in the patient or the clinical variables. RESULTS: The mean age was 47.8 years. There was no statistical correlation between angiogenesis and either estrogen receptor status or age. However, there was a statistical correlation with tumor size (p< or =0.05). There was a statistical difference between lymph-node-metastasis positive group and negative group (p= 0.006). Angiogenesis correlated statistically with TMN stage (microvessels count:stage I= 31.27, stage II= 40.74, and stage III= 78.9)(p= 0.001). There was a statistical correction between angiogenesis and follow-up results (microvessels counts:disease free group= 42.11, living metastatic group= 63.64, and expired group= 73.60)(p= 0.031). CONCLUSIONS: In this study, the degree of angiogenesis (the number of microvessels per 200 field in the area of most intensive neovascularization) may have a predictive value in invasive breast carci nomas. Therefore, assessment of tumor angiogenesis may give us useful information for selecting thera peutic and follow-up plan for patients with breast carcinomas.