Fuller AM, Olsson LT, Midkiff BR, et al. - The researchers developed a digital algorithm in order to quantitate vascular density in about 300 histologically benign tissue specimens from breast cancer subjects recruited in the UNC Normal Breast Study. For CD31, specimens were stained, and vascular content was contrasted with demographic variables, tissue composition metrics, and tumor molecular characteristics. In elderly and obese women the vascular density of cancer-adjacent breast was significantly higher and was strongly correlated with breast adipose tissue content. Constant with conclusions that elderly and heavier women encounter higher frequencies of ER₊ disease, higher extratumoral vessel density also had a marked relationship with positive prognostic tumor features like the lower stage, negative nodal status, and smaller size (< 2 cm). Hence, biological relationships among extratumoral vascular content and body size, breast tissue composition, and tumor features were demonstrated and biological plausibility for the association between weight gain (and corresponding breast tissue changes) and breast cancer progression was also proposed.