There is still uncertainty about angiogenesis as a prognostic factor in breast cancer. The aim of this study was to evaluate the prognostic value of microvascular density (MVD) in breast carcinoma and soluble vascular cell adhesion molecule- 1 (sVCAM-1), leptin, estradiol and total testosterone as angiogenic markers. Efficacy of shark care drug was assessed by patient’s overall survival. In this study there were 30 premenopausal breast cancer patients (group II) and 15 controls (group I). Group II was subgrouped into 15 patients receiving chemotherapy alone (IIA) and 15 patients receiving chemotherapy + shark care drug (IIB). After modified radical mastectomy, microvessels were counted by staining tissues for factor VIII. For surrogate markers, enzyme-linked immunosorbant assay or radioimmunoassay kits were used. A high MVD was found only in areas of carcinoma. MVD and sVCAM-1 correlated significantly with each other and with lymph node involvement. After the follow up, all subgroup IIB patients were alive compared to 66.6% of subgroup IIA patients (p=0.02). A high MVD may be a poor prognostic marker of breast carcinoma and a target for antiangiogenic therapy. sVCAM-1 is useful for diagnosis and for monitoring response to therapy. Chemotherapy + shark care drug seem to ameliorate the outcome of these patients. [Turk J Cancer 2008;38(3):123-134]