A Retrospective Study of Association of Tumor Budding, Tumor Microenvironment, and Clinicopathological Characteristics of Invasive Breast Carcinoma

Abstract

Background Tumor budding (TB) has been identified in many solid cancers and thought to be involved in invasion and is the initial step in the metastatic process. Limited information is available documenting the role of tumor budding in breast carcinoma. With this aim, the present study evaluates the association of tumor budding, tumor microenvironment, and its correlation with clinicopathologic parameters. Materials and Methods A total of 102 cases were archived and evaluated for peripheral and intra tumoral budding along with tumor microenvironment on hematoxylin and eosin (H&E) slides. Statistical Analysis Correlation between tumor budding, tumor microenvironment, and other classical clinicopathological parameters was studied by Chi-square test. A p-value less than 0.05 was considered significant. Results Females constituted 99 cases out of 102 and 3 were males. We found 55.9% and 44.1% of patients in the age group less than or equal to 50 and greater than 50, respectively. Also, 65.6% of cases presented with small tumor size less than or equal to 5 cm, 80.39% with lymph node metastasis, and 76.4% with lympho-vascular emboli. High peripheral tumoral budding (PTB) was seen in 45.10%, low peripheral tumoral budding in 54.9%, high ITB in 53.9%, and low ITB in 46.1%. Necrosis was found only in 39.21%. Significant statistical association of PTB was found with lymph node metastasis, lymphovascular emboli, and tumor necrosis, whereas ITB with tumor grade, lymph node metastasis, lympho-vascular emboli, and necrosis. Both PTB and ITB showed no statistically significant correlation with age and size of the tumor. Conclusion Tumor budding is an independent adverse prognostic factor in invasive breast carcinoma. However, further work is needed to establish a standard method for the quantification of this parameter, which will help in effective stratification of patients in terms of disease-free survival and likely outcome.

Tumor budding in invasive breast carcinoma: correlation with clinicopathological parameters, hormone receptor status, and survival: an observational study

“…Therefore, many previous studies have found similar associations between TB and LVI, pT, and axillary lymph node metastasis 4 , 6 , 8 , 15 , 17 – 20 . In line with them, we found a significant association.…”

“…In the ensuing years, it has been studied in many solid organ malignancies as a prognostic marker 4 , 13 , 14 . Therefore TB is advocated as a more sensitive prognostic factor, a predictor of aggressiveness and a worse outcome 4 , 6 , 15 .…”

The Relationship Between Tumor Budding and Patient’s Survival in Breast Cancer

“…Group I (grade I), tumor with 0 to 4 tumor buds, Group II (grade II), tumor with 5 to 10 tumor buds; and Group III (grade III), tumor with more than 10 tumor buds. 17 …”

A Cross-Sectional Study of Tumor Budding in Correlation with Clinicopathological Parameters in Invasive Breast Carcinoma

“…Tumor budding is associated with various clinicopathological characteristics like age, laterality, tumor size, tumor grade, histological subtypes, inflammation, lymph node and, lymphatic/vascular invasion, ER, PR, Her2Neu, treatment status, pTN-Mstaging [3][4][5] . Tumor buds are helpful in predicting the response to neoadjuvant chemotherapy in breast carcinoma patients [5] .…”