ABSTRACT
Introduction: Tumor budding (TB) is proposed as an essential step in the invasion and metastasis of various tumors. However, there is limited information about its role in breast cancer. This study was designed to assess the prognostic significance of TB in clinical practice. Objectives: To study and grade TB in patients with invasive breast cancer and to correlate it with known prognostic parameters. Materials and Methods: In this prospective study, 40 cases of invasive breast cancer were studied over a period of 1.5 years. Tumor buds were defined as comprising five tumor cells or less at the invasive front of the tumor. Cases were separated into two groups according to TB density as low grade and high grade. Significance and correlation between TB with established clinicopathological parameters and hormone receptor status were studied by Chi-square test. P value <0.05 was considered significant. Results: All 40 cases in this study were newly diagnosed cases, who did not receive any therapy. The majority of patients were premenopausal (55%), had small tumor size ?5 cm (67.5%), had negative lymph nodes (67.5%), had grades 2 and 3 (75%), and presented in stages 1 and 2 pathological stage (62.5%). The majority were estrogen-receptor-negative (62.5%), progesterone-receptor-negative (65%), and human epidermal growth factor receptor-2-positive (52.5%). Higher grade TB was observed in larger tumor (P = 0.03), in higher stage (P = 0.046), and in tumor having lymphovascular emboli (P = 0.03) when compared with small size, lower stage, and tumor with no lymphovascular emboli, respectively. Conclusion: As higher grade TB was associated with larger, higher stage tumor, and in tumor having lymphovascular emboli, it can be recognized as an easily identifiable prognostic factor.
ABSTRACT
Introduction:Aberrant DNAmethylation patterns in serum DNAmight be used as a biomarker for the early diagnosis and management of cancer patients. The aim of present study was to evaluate DNAmethylation of RASSF1Aand CDH1 in circulating cell free DNA(cfDNA) from serum and paired tissue DNAsamples of breast cancer patients. Material and methods: Methylation-specific PCR was used to assess the methylation status of the two genes in serum and paired tissue sample DNAof 50 breast cancer patients. Biochemical parameters were assessed using an electrochemiluminescence analyzer. Results: Significant correlation found between methylation status of RASSF1A and CDH1 in serum and paired tissue samples of patients. Among clinicopathological findings, CDH1 methylation showed significant association with advance staging and tumor and methylation of RASSF1A exhibited significant association with progesterone receptor and estrogen receptor status in both serum and paired tissue. Vitamins levels were significantly high in cases compared to control group. High folic acid levels were significantly associated with the RASSF1Amethylation. Conclusions: These findings suggest that methylation of cfDNAmay be important in the early detection of breast cancer.