Tumor budding in invasive carcinoma of breast of No Special Type (NST): Value as a prognostic factor

Abstract

Context: Tumor budding refers to single or small cluster of tumor cells detached from the main tumor mass in histological sections. In colon cancer high tumor budding is associated with worse prognosis, correlates with metastatic lymph nodes and is included in the protocol for reporting colectomy specimens. We studied tumor budding in mastectomy specimens of cases of breast carcinoma of no special type (NST)to evaluate its utility as a prognostic factor by correlating tumor budding, both intratumoral and peripheral tumoral, with other known prognostic markers of breast cancer like lymph nodal metastasis, tumor size, lymphovascular emboli and grading. Aims:To evaluate tumor budding in invasive ductal carcinoma (IDC) NST with: l.ymph node metastasis; 2.lymphovascular invasion (LVI); 3.Grading by Nottingham modification of Bloom-Richardson (NBR) and other prognostic parameters like age, tumor size, and ER status. Methods and Material: The present study is a prospective study of all Modified Radical Mastectomy (MRM) specimens received and examined from 1st January 2018 to 30thJuly 2018. Along with tumor budding various prognostic parameters were evaluated. Immunohistochemical marker Pancytokeratin was utilized for counting the tumor buds, wherever necessary. Statistical Analysis: Chi Square test was utilized to study significant differences between variables. A p value < 0> Results: A greater number of tumor buds both intratumoral (ITB) and peritumoral (PTB) were associated with lymph node metastasis and lymphatic invasion whereas ITB also correlated with NBR grading. Conclusion: In our study we detected the association of high tumor budding, both ITB and PTB in invasive ductal carcinoma (NST) and also noted association with known poor prognostic markers. Hence our results highlight the importance of tumor budding as a prognostic factor and submit that this histological feature could be included indiagnostic protocols just as in carcinoma of the colon. Keywords: