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Breast cancer is the most frequent malignancy in women worldwide. In spite of  its questionable reliability, the TNM (Tumor, Node, Metastasis) staging  system is widely used for the prognosis of this disease. On the other hand,  angiogenesis is considered to have an essential role in the evolution of  breast cancer and the Vascular Endothelial Growth Factor (VEGF) has proven to  be the key regulator of this process. Quantitation of VEGF and the tumor  vasculature might play an important role in predicting tumor behavior and  patient management. The aim of our study was to evaluate the potential  correlation between the VEGF expression, microvessel density (MVD) in the  tumor tissues and TNM staging in breast cancer. We included 34 patients with  breast cancer who had undergone surgical treatment and evaluated each case  clinically, histopathologically and by immunohistochemistry for VEGF and CD31  expression in the tumor tissues. VEGF expression was evaluated by calculating  the average percentage of cytoplasmic positive cells from 3 high power  fields. MVD was expressed as the average number of the CD31+ microvessels  from 3 high power fields. Expression of VEGF was significantly associated  with the number of lymph nodes with metastasis, the number of cells in  mitosis, the presence of necrosis and the T-stage (inverse correlation). MVD  correlated very well with the histological grading, the number of cells in  mitosis, the presence of inflammation and the presence of necrosis. No  correlation could be established between VEGF expression and MVD. Although  their relationship with TNM staging remains unclear, VEGF expression and MVD  proved to be important indicators of the malignant status in breast cancer,  confirming the major involvement of angiogenesis in this type of cancer. Both  of them are valuable prognostic factors in breast cancer, but the pattern of  their relationship needs further analysis of the VEGF receptors in order to  be described

Correlations between vascular endothelial growth factor expression, microvascular density in tumor tissues and TNM staging in breast cancer