Centre for Cancer Biomarkers CCBIO
CCBIO doctoral defense

Biomarkers in aggressive breast cancer

Kristi Krüger defended November 8th her dissertation “Markers of angiogenesis and the basal-like phenotype of breast cancer”. The study has given increased knowledge of the aggressive basaloid type of breast cancer.

Group photo of the candidate with opponents and supervisors.
The doctoral candidate with supervisors and evaluation committee. From the left: Elisabeth Wik, Leiv M. Hove, Hans Petter Eikesdal, Kristi Krüger, Karin Jirström, Anne Christine Johannessen and Lars A. Akslen.

Main content

Measuring proliferating blood vessels in breast cancer

Cancer is a disease in which genetic changes lead to uncontrolled cell division. In order for a cancerous tumor to grow beyond microscopic size, the tumor must establish blood supply through a process called angiogenesis, new blood vessel growth.

Breast cancer is the most common cancer among women. Using new analyzes, tumors can be divided into subgroups with different biology, treatment and prognosis. Basaloid subtype is a form of breast cancer that is often more aggressive than the average and at the same time has few known treatment options.

The density of blood vessels and proportion of blood vessels with active cell division, so-called proliferating blood vessels, were measured in tissue samples from breast cancer patients. High proportion of proliferating blood vessels was associated with basaloid subtype, aggressive cancer disease, and poorer prognosis.

Inhibiting new blood vessel growth

We also investigated tissue samples from breast cancer patients in a clinical study where half received standard treatment with chemotherapy, and the other half were in addition given anti-angiogenic treatment in the form of a drug that would inhibit new blood vessel growth. In patients with high blood vessel density at the time of diagnosis, there were more who had an effect of anti-angiogenic treatment than those with lower blood vessel density.

We registered protein and gene expression of the biomarker Nestin in tissue samples from breast cancer patients. Nestin proved to be a good marker for basaloid subtype and poor prognosis. Patients with hereditary disposition for breast cancer through mutation in the BRCA1 gene had more often Nestin-positive cancer tissue samples.

New knowledge

The study has given increased knowledge of the aggressive basaloid type of breast cancer. In addition, angiogenesis-related markers show association with poor prognosis and response to anti-angiogenic treatment.


Kristi Krüger (born 1987) was born and raised in Bergen, has an MD from the University of Bergen (2014), and is currently an intern at Haukeland University Hospital. Her doctoral thesis is a continuation of her project at the Medical Student Research Programme. The study is carried out at the Department of Clinical Medicine (K1) and the Centre for Cancer Biomarkers CCBIO at the University of Bergen, and the Department of Pathology, Haukeland University Hospital. Main supervisor was Professor Lars A. Akslen, and co-supervisor was MD PhD Elisabeth Wik.