posted on 2016-01-21, 16:30authored byAoife J. Lowery, Karl J Sweeney, Alan P Molloy, Emer Hennessy, Catherine Curran
Background: Vascular endothelial growth factor (VEGF) is a potent angiogenic cytokine produced
physiologically by the uterus. Pathological secretion by tumours promotes growth and metastasis.
High circulating VEGF levels potentially have a deleterious effect on breast cancer by promoting
disease progression.
The aims of this study were to investigate circulating VEGF levels in breast cancer patients and
assess the effect of menopause or hysterectomy on systemic VEGF.
Methods: Patients undergoing primary surgery for breast cancer and controls matched for age,
menopausal and hysterectomy status were prospectively recruited. Serum VEGF, FSH, LH,
estrogen, progesterone and platelet levels were measured. Serum VEGF was corrected for platelet
load (sVEGFp) to provide a biologically relevant measurement of circulating VEGF. SVEGFp levels
were analyzed with respect to tumor characteristics, menopausal status and hysterectomy status.
Results: Two hundred women were included in the study; 89 breast cancer patients and 111
controls. SVEGFp levels were significantly higher in breast cancer patients compared to controls (p
= 0.0001), but were not associated with clinico-pathological tumor characteristics. Systemic VEGF
levels reduced significantly in the breast cancer patients following tumor excision (p = 0.018). The
highest systemic VEGF levels were observed in postmenopausal breast cancer patients.
Postmenopausal women who had had a previous hysterectomy had significantly higher VEGF levels
than those with an intact postmenopausal uterus (p = 0.001).
Conclusion: This study identifies an intact postmenopausal uterus as a potential means of reducing
circulating levels of VEGF which could confer a protective effect against breast cancer metastatic potential.