Does the number of cell forming tumor budding alter the prognostic value in invasive ductal carcinoma of breast?

Abstract

The most commonly used definition for tumor budding (TB) is a single or a cell cluster of tumor cells up to 4 cells. However, there are different opinions regarding the number of cell (NOC) forming TB. It has been proven that TB is associated with poor prognostic factors in most tumors. The current study, it was aimed to investigate the prognostic value of NOC forming TB in invasive ductal carcinoma of the breast. 326 cases with the diagnosis of invasive ductal carcinoma were examined. The NOC forming TB was counted from hematoxylin and eosin stained slide under X200 magnification for each case, and scoring five different TB as 1, ≤2, ≤3, ≤4, ≤5, respectively. Receiver operating characteristic (ROC) analysis based on survival was performed for each TB value separately, and the cut-off was determined. All TB values were associated with poor outcome (p<0.001), presence of distant metastasis (p<0.001), high Ki67 proliferation index (p<0.05), advanced stage (p<0.05), presence of lymphovascular invasion (p<0.001), and metastatic axillary lymph node (p<0.001). According to ROC analysis performed to compare the predictiveness of survival, the area under the curve was similar for all TB values. TB was associated with poor prognostic parameters, and the prognostic value of TB was not affected by NOC forming TB. The NOC up to 4 cells which have been accepted for colon carcinomas, could also provide practicality in breast carcinomas.