Association of angiogenesis and poor prognosis in node-positive patients receiving anthracycline-based adjuvant chemotherapy

Tumoral angiogenesis has been described as associated with poor prognosis in breast cancer, particularly for node negative breast cancer. The purpose of this study was to evaluate the influence of angiogenesis in node-positive breast cancer and particularly its potential impact on adjuvant chemotherapy. Patients and methods: One hundred and thirty-five node-positive breast cancer patients who received anthracycline or derivative based adjuvant chemotherapy were selected from the data base of the Institut Paoli Calmettes. Angiogenesis was evaluated using CD31 antibody. Other prognosis variables studied were: hormonal status, tumor size, hormonal receptors, Elston and Ellis grade, and number of involved lymph nodes. Results: In multivariate analysis, a high level of angiogenesis was independently associated with a diminution of survival (p=0.007), and of metastasis-free survival (p=0.003). Other variables associated with poor survival were progesterone receptor status (p=0.003) and Elston' grade (p=0.003), and with metastasis-free survival, progesterone receptor status (p=0.018). Conclusion: Tumoral angiogenesis appears to be an independent prognostic factor for node-positive breast cancer, when treated with adjuvant chemotherapy. Adjuvant strategies for patients with a high level of angiogenesis should be discussed.