Manimaran Poornima, Shah Ashini, Gami Amisha, Gandhi Jahnavi, Kakoty Sneha, Rai Varnika, Trivedi Priti P
Department of Oncopathology, Gujarat Cancer Research Institute, Ahmedabad, India.
South Asian J Cancer. 2024 Aug 28;14(1):38-44. doi: 10.1055/s-0044-1789582. eCollection 2025 Jan.
Breast cancer is a highly heterogenous tumor with different subtypes showing varying prognosis. Tumor budding is an unfavorable histological feature of many epithelial cancers. The purpose of this study is to analyze the association between tumor bud density with various histological and immunohistochemical characteristics and to explore its prognostic role in breast carcinoma.
A retrospective analysis was performed on 100 patients of breast cancer diagnosed in our institute from January to December 2017. Hematoxylin and eosin (H&E) stained slides from tumors and immunohistochemical slides were reviewed independently by two pathologists, and clinical data were acquired from computerized records. Patients on neoadjuvant chemotherapy were excluded from the study.
The study comprised 100 patients of invasive breast carcinoma. The median age was 52 years, and 96% were invasive ductal carcinoma. The median follow-up was 34 months. High tumor bud density was substantially correlated with primary tumor staging (T3, T4; 73% [11/15] cases) and lymph node staging (N2, N3; 68% [13/19] cases) with -values of 0.017 and 0.023, respectively. Systemic metastasis (85% [6/7] cases) was significantly associated with high tumor bud density ( =0.025) but lymphovascular invasion (LVI) and perineural invasion (PNI) were not significantly associated with tumor bud density ( = 0.762 and 0.862, respectively). Patients with N2 nodal stage had low event-free survival rate than N0/N1 nodal stage irrespective of tumor bud status. Grade 3 tumors with high tumor bud density had worse event-free survival than any other grades. There was no association of tumor bud density with tumor staging, necrosis, PNI, LVI, estrogen receptor (ER), progesterone receptor (PR) and , and event-free survival.
Strong relationships have been found between tumor bud density and poor prognostic variables such as primary tumor staging and lymph node staging. These results provide credence to the idea that tumor bud density can be an assessable prognostic feature that should be taken into account while reporting breast cancer cases. Tumor bud density evaluation has to be standardized nevertheless if it is to be widely adopted.
乳腺癌是一种高度异质性肿瘤，不同亚型预后各异。肿瘤芽生是许多上皮性癌症的不良组织学特征。本研究旨在分析肿瘤芽密度与各种组织学和免疫组化特征之间的关联，并探讨其在乳腺癌中的预后作用。
对2017年1月至12月在我院诊断的100例乳腺癌患者进行回顾性分析。两名病理学家独立复查肿瘤的苏木精和伊红（H&E）染色切片以及免疫组化切片，并从计算机记录中获取临床数据。接受新辅助化疗的患者被排除在研究之外。
该研究包括100例浸润性乳腺癌患者。中位年龄为52岁，96%为浸润性导管癌。中位随访时间为34个月。高肿瘤芽密度与原发肿瘤分期（T3、T4；73%[11/15]病例）和淋巴结分期（N2、N3；68%[13/19]病例）显著相关，P值分别为0.017和0.023。全身转移（85%[6/7]病例）与高肿瘤芽密度显著相关（P = 0.025），但淋巴管侵犯（LVI）和神经周围侵犯（PNI）与肿瘤芽密度无显著关联（P分别为0.762和0.862）。无论肿瘤芽状态如何，N2淋巴结分期患者的无事件生存率低于N0/N1淋巴结分期患者。高肿瘤芽密度的3级肿瘤的无事件生存率比其他任何级别都差。肿瘤芽密度与肿瘤分期、坏死、PNI、LVI、雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2）以及无事件生存率均无关联。
已发现肿瘤芽密度与不良预后变量如原发肿瘤分期和淋巴结分期之间存在密切关系。这些结果为肿瘤芽密度可作为一种可评估的预后特征这一观点提供了可信度，在报告乳腺癌病例时应予以考虑。不过，如果要广泛采用肿瘤芽密度评估，就必须使其标准化。
