Plasma vascular endothelial growth factor is useful in assessing progression of breast cancer post surgery and during adjuvant treatment.

Vascular endothelial growth factor (VEGF) has been shown to induce angiogenesis in vivo and in vitro. However, the association of plasma VEGF with tumor histopathology in high risk groups such as African American and non-white Hispanic women with breast cancer is not well understood. There is limited information on the prognostic relevance of plasma VEGF in patients who have had surgery and adjuvant treatment for breast cancer. In this study, we measured plasma VEGF from 125 minority women with primary breast tumor removal and were completing adjuvant treatment. The control group consisted of 20 subjects without cancer. We examined the association between plasma VEGF and other tumor characteristics such as steroid hormone receptors, tumor size, regional nodes, stage, recurrence, and overall survival. Our results confirmed that plasma VEGF levels were significantly higher in breast cancer patients than normal subjects. Plasma VEGF level increased in patients with increase in tumor size, and at late stage III/IV disease. Univariate analysis showed plasma VEGF to be a significant predictor of overall survival (RR=2.5, p=0.02). Multivariate analysis showed plasma VEGF not only to be an independent predictor of overall survival (RR=4.6, p=0.02) but also of local recurrence (RR=6.0, p=0.04). Tamoxifen in combination with CMF or CAF can reduce plasma VEGF level in patients with estrogen receptor positive tumor but not in estrogen receptor negative tumor. Our findings suggest that plasma VEGF should be considered as a tumor marker for breast cancer progression, and inhibitors of angiogenesis should be factored into the treatment protocol for patients who demonstrate increase in plasma VEGF levels at any stage of the disease.