Clinicopathologic Features of Breast Carcinomas Classified by Biomarkers and Correlation with Microvessel Density and VEGF Expression: A Study from Thailand


Background: To correlate breast cancer subtypes with prognostic factors, microvessel density (MVD),vascular endothelial growth factor (VEGF) expression and clinical features. Materials and
Methods: Onehundred cases of primary breast carcinoma were classified using biomarkers on tissue microarray as: luminalA [estrogen receptor (ER)+, HER2-, Ki-67≤14%], luminal B [ER+, HER2+ or ER+, HER2-, Ki-67>14%],HER2, triple negative basal-like (TNB) [any basal cytokeratins (CKs, 5, 14, 17) and/or endothelial growth factorreceptor (EGFR) expression], and TN without such markers [TNN, null], and assessed for p53, vimentin, VEGFand CD31 immunoperoxidase.
Results: Of the 100 cases (mean age, 51 years; mean tumor size, 3.2cm; 56%with nodal metastasis; 89 invasive ductal carcinomas, not otherwise specified, 4 invasive lobular carcinomas,3 metaplastic carcinomas, and 4 other types) there were 39 luminal A, 18 luminal B, 18 HER2, 15 TNB and10 TNN. The positivities of basal-like markers in the basal-like subtype were 78.3% for CK5, 40% for CK14,20% for CK17, 46.7% for EGFR. There was no significant difference in age distribution, tumor size, degreeof tubular formation, pleomorphism, lymphovascular invasion, nodal metastasis, MVD, VEGF expression andsurvival among subgroups. TNs demonstrated significantly higher tumor grade, mitotic count, Ki-67 index, p53and vimentin and decreased overall survival compared with nonTN.
Conclusions: The distribution of breastcancer subtypes in this study was similar to other Asian countries with a high prevalence of TN. The high gradecharacter of TN was confirmed and CK5 expression was found to be common in our basal-like subtype. Nosignificant elevation of MVD or VEGF expression was apparent.