Tumor Budding is a reliable predictor for death and metastasis in invasive ductal breast cancer and correlates with other prognostic clinicopathological parameters

Okçu, Oğuzhan; Öztürk, Çiğdem; Şen, Bayram; Arpa, Medeni; Bedir, Recep

doi:10.1016/j.anndiagpath.2021.151792

Cited by 14 publications

(18 citation statements)

References 25 publications

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“…We also demonstrated that TB was associated with age, menopausal status, T stage, TNM stage, and LNM status. Consistent with previous studies ( 39 ), our study showed that TB was an independent prognostic factor of BC patients. In BC, which is highly heterogeneous, prognosis varies widely among different subtypes.…”

Section: Discussionsupporting

confidence: 93%

Breast Cancer Classification Based on Tumor Budding and Stem Cell-Related Signatures Facilitate Prognosis Evaluation

Xiang

Huang

et al. 2022

Front. Oncol.

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BackgroundTumor budding (TB) is emerging as a prognostic factor in multiple cancers. Likewise, the stemness of cancer cells also plays a vital role in cancer progression. However, nearly no research has focused on the interaction of TB and tumor stemness in cancer.MethodsTissue microarrays including 229 cases of invasive breast cancer (BC) were established and subjected to pan-cytokeratin immunohistochemical staining to evaluate molecular expression. Univariate and multivariate analyses were applied to identify prognostic factors of BC, and the Chi-square test was used for comparison of categorical variables.ResultsHigh-grade TB was significantly associated with T stage, lymph node metastasis, tumor node metastasis (TNM) stage, epithelial-mesenchymal transition, and poor disease-free survival (DFS) of BC patients. We also found that the prognostic value of TB varied widely among different subtypes and subgroups. Cox regression analysis then showed that TB grade was an independent prognostic factor. Moreover, cancer stem cell (CSC) markers CD44 and ALDH1A1 were significantly higher in high-grade TB tumors. Consequently, patients were classified into high CSC score subgroup and low CSC score subgroups. Further research found that CSC scores correlated with clinicopathological features and DFS of BC patients. Based on TB grade and CSC scores, we classified BC patients into TBlow-CSCslow (type I), TBlow-CSCshigh (type II), TBhigh-CSCslow (type III), and TBhigh-CSCshigh (type IV) subgroups. Survival analysis showed that patients in the type I subgroup had the best DFS, whereas those in the type IV subgroup had the worst DFS. Finally, a TB-CSC-based nomogram for use in BC was established. The nomogram was well calibrated to predict the probability of 5-year DFS, and the C-index was 0.837. Finally, the area under the curve value for the nomogram (0.892) was higher than that of the TNM staging system (0.713).ConclusionThe combination of TB grade with CSC score improves the prognostic evaluation of BC patients. A novel nomogram containing TB grade and CSC score provides doctors with a candidate tool to guide the individualized treatment of cancer patients.

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Section: Discussionsupporting

confidence: 93%

Breast Cancer Classification Based on Tumor Budding and Stem Cell-Related Signatures Facilitate Prognosis Evaluation

Xiang

Huang

et al. 2022

Front. Oncol.

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“…Breast cancer is the most prevalent type of cancer and the most lethal and recurrent cause of death. Invasive ductal papillary cancer is the subtype and most common type of breast cancer, and it comprises approximately 80% of all cases [ 1 , 2 ]. Despite advancements in diagnostic and treatment options, breast cancer-related death is still high.…”

Section: Introductionmentioning

confidence: 99%

Comparison of ultrasonographic and mammographic features of extremely rare papillary carcinoma and invasive ductal carcinoma

Balsak¹,

Yozgat²,

Yüzkan³

et al. 2022

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Introduction This study aimed to investigate and compare ultrasonographic and mammographic findings of papillary breast carcinoma and invasive ductal carcinoma in breast masses that were diagnosed as pathological. Material and methods This retrospective study included 88 patients with breast lesions, who underwent ultrasonography, mediolateral oblique-craniocaudal, and tomosynthesis imaging in the Picture Archiving and Communication System between January 2010 and March 2019. Results 44 histopathologically diagnosed papillary carcinoma patients and 44 invasive ductal carcinoma patients were divided into groups according to contour, shape, internal structure, calcific-cystic component, echogenicity, posterior acoustic change, skin orientation, and environmental echogenic halo. There was a statistically significant difference between the groups in mammography contour, U/S contour, U/S shape, U/S posterior acoustics, and U/S internal structure. Logistic regression analysis showed that the presence of homogenous appearance ( p < 0.001) and absence of shading in the posterior acoustic U/S ( p = 0.001) were the most pertinent findings for determining papillary carcinoma. In the U/S, the likelihood of a homogenous tumour being a papillary carcinoma was 16.869 times higher than that of invasive ductal carcinoma, whereas the same probability was 0.1101 times less for a tumour with posterior acoustic shadowing. Conclusions It is challenging to differentiate between invasive ductal carcinoma and papillary carcinoma of the breast without histopathological diagnosis both on ultrasound and mammography. The results of our study demonstrated that the ultrasonographic and mammographic findings of invasive ductal carcinoma and papillary carcinoma were like each other. Therefore, it is still not possible to distinguish between these 2 types of cancer only in accordance with these 2 criteria.

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“…Tumor budding is observed much less frequently in endometrioid endometrial carcinomas compared to colon, breast, stomach, and lung carcinomas. 5, 8, 25 This suggests that the reason why endometrioid endometrial carcinomas generally have a better prognosis and survival. However, as detected in our study, even among tumors of low stage and low grade in endometrioid endometrial carcinomas, a single tumor budding (1/0.95 mm 2 ) creates a significant difference in survival.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been identified as an independent poor prognostic parameter in these tumors. [5][6][7][8] Different assessment and scoring systems have been proposed for tumor budding for many years, and in 2016, tumor budding assessment method and scoring in colorectal carcinomas have been standardized in the International Tumor Budding Consensus Conference (ITBCC). 9 Then, it took place as an additional prognostic factor for colorectal cancers in recent CAP cancer reporting protocol in 2019.…”

Section: Introductionmentioning

confidence: 99%

Tumor Budding is an Independent Prognostic Factor to Predict Overall Survival in Endometrial Endometrioid Carcinoma: A Retrospective Study

et al. 2022

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Objective. Tumor budding defined as a tumor cell nest away from the main tumor, has been found to be associated with prognostic parameters in many cancer types. We aimed to investigate the relationship between tumor budding and clinicopathological parameters in endometrioid endometrial carcinomas, as well as its prognostic importance. Materials and Methods. One hundred four patients who underwent surgical resection with diagnosis of endometrioid endometrial carcinomas between June 2011 and May 2020 were included. The area where tumor budding was the most prominent was determined, and tumor budding was counted from hematoxylin and eosin-stained section at one high power field (X 200). By performing ROC analysis, the cut off value was obtained in order to divide the patients into low and high tumor budding groups. Results. The cut off value was determined as 1/0.95 mm2 according to the ROC analysis. Tumor budding was observed in 24 (23%) patients. Tumor budding significantly associated with poor overall survival ( P < .001), distant metastasis ( P = .001), presence of angiolymphatic invasion ( P < .001), lymph node metastasis ( P = .024), cervical invasion ( P < .001), high FIGO grade ( P < .001), large tumor size ( P = .004). In multivarate analysis, tumor budding and age were found to be an independent risk factor for overall survival ( P = .003, P = .014 respectively). Conclusion. Tumor budding is a significant morphological parameter independent of other prognostic parameters in endometrioid endometrial carcinomas. Standardizing the assesment and scoring of tumor budding, as well as including this entity in routine pathology reports could light the way for ideas in the risk analysis of patients.

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Tumor Budding is a reliable predictor for death and metastasis in invasive ductal breast cancer and correlates with other prognostic clinicopathological parameters

Cited by 14 publications

References 25 publications

Breast Cancer Classification Based on Tumor Budding and Stem Cell-Related Signatures Facilitate Prognosis Evaluation

Breast Cancer Classification Based on Tumor Budding and Stem Cell-Related Signatures Facilitate Prognosis Evaluation

Comparison of ultrasonographic and mammographic features of extremely rare papillary carcinoma and invasive ductal carcinoma

Tumor Budding is an Independent Prognostic Factor to Predict Overall Survival in Endometrial Endometrioid Carcinoma: A Retrospective Study

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