D-Dimer Levels In Breast Carcinoma: A Clinico-Pathologic Study

Abstract

Background: Breast cancer is the most common cause of death in women by neoplasia. Plasma D-dimer is a hypercoagulability and fibrinolytic system marker, which is produced when factor XIIIa (a cross-linked fibrin) is degraded by plasmin. It is increased in various solid tumour patients including breast, lung, prostate, cervical and colorectal cancers.Methods: 30 patients of breast carcinoma who underwent radical mastectomy (cases) and 30 cases without carcinoma (controls) were included. The baseline parameters (D-dimer levels) were measured in both cases and controls. From each patient, whole blood was collected and Quantitative D-dimer levels were obtained by Diazyme's D-dimer Assay using the instrument, RANDOX Rx imola. Other parameters such as histopathological features, hormonal receptors (ER & PR) and HER2/neu status were studied in cases.Result: Mean plasma D-dimer levels were significantly higher in patients with breast carcinoma before surgery as compared to after surgery (p<0.001). Quantitative D-dimer levels highly correlated with lymph node status and histopathological grading (p=0.003, p=0.015 respectively). Conclusion:Our study showed that high plasma D-dimer levels can be used as a marker for lymph node involvement and higher histopathological grade. Due to the ease with which plasma D-dimer levels can be obtained and its cost effectiveness, quantitative D-dimer levels can be added to models for predicting axillary lymph node involvement.