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Abstract
Breast Cancer is the most common malignant tumor affecting female .One of nine women will develop the disease during their lifetime.
The research for a predictive factor for distant metastasis and local metastasis is goal for most of researches now.
Multiple studies have shown that angiogenesis plays an important role in the growth, progression and metastasis of the cancer breast.
It depends on production of the Angiogenic factors by the host and or tumor cell, and there are two different types of angiogenesis, vascular and lymphatic,
The vascular angiogenesis is responsible of spread of the tumor cell in the systemic circulation and lymphatic angiogenesis, is responsible of spread of the tumor cell into the axillary lymph nodes.
Our study which include 40 patients with cancer breast were subjected to surgery according to Milan criteria and bone marrow biopsy intra-operative was taken from them and the tumor tissue was stained by factor VIII for assessment of vascular angiogenesis and VEGRF3 for assessment of lymphatic angiogenesis and we aimed to investigate the relation between vascular density and lymphatic density of operable cancer breast tumor to predict the loco-regional and distant metastasis and to identified the groups that may have distant metastasis at the time of surgery that is way we can change the adjuvant therapy for the patients.
In our study, we found that Chalkely vascular density was significantly associated with Tumor size and type of the tumor but they were independent predictors for bone marrow metastasis.
The Chalkley lymphatic count is a good predictive factor for axillary lymph node involvement and more of that we detected the cutoff point of new lymph vessel (its value above 5 new vessel/ 0.196mm².Above this value , mean positive axillary lymph node while below it means negative axillary lymph nodes.
We found four cases (10%) with bone marrow micrometastasis at time of surgery in spite of they appeared clinically free from metastasis at the time of surgery even with bone scanning. chalkely vascular count and Chalkley lymphatic count in those cases were high but not significant related to bone marrow micrometastasis.