Evaluation of prognostic role of tumour budding in breast carcinoma and its correlation with known clinicopathological parameters

Abstract

Tumour budding (TB) consists of a small group of cells (upto 5) which have detached from the tumour bulk. TB has been studied in many malignancies including head and neck, colorectum, oesophagus, etc. However there are very few studies to determine its role in Breast cancer. This study was designed to study the role of tumour budding as a prognostic factor in Breast cancer. To study the grade of TB in Invasive Breast Carcinoma and correlate it with known clinicopathological parameters to determine its usefulness as a prognostic factor. In this retrospective observational study, 40 cases of modified radical mastectomy from July 2019 to December 2020 were evaluated for the tumour budding. Ethical clearance was not required as it was a secondary data collection study which did not relate to patient’s privacy, clinical examination or treatment. Significance and correlation was studied between the grade of TB and known clinicopathological parameters using Chi-square test. Out of the 40 cases evaluated, 20 cases (50%) were of High grade TB (>/=10/10HPF), while 20 cases (50%) were of Low grade TB (<10/10HPF). Majority patients were of age group 40-60 years (60%), with primary carcinoma (52.5%) and invasive ductal type (72.5%). Higher TB was observed with Lymphnode positive cases (p=0.002), in higher TNM stage (p=0.006) and with lymphovascular invasion (p=0.000). As higher grade tumour budding was associated with positive lymphnode status, higher tumour stage and presence of lymphovascular invasion, it can be considered as an indicator of poor prognosis in cases of breast carcinoma especially in resource poor institutes which are not equipped with sophisticated IHC and Molecular markers.