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High tumor budding stratifies breast cancer with metastatic properties.

Salhia B, Trippel M, Pfaltz K, Cihoric N, Grogg A, Lädrach C, Zlobec I, Tapia C - Breast Cancer Res. Treat. (2015)

Bottom Line: The results were correlated with pathological parameters.This risk assessment can be easily performed during routine diagnostics and it is time and cost effective.These results suggest that high PTB is associated with loco-regional metastasis, highlighting the possibility that this tumor feature may help in therapeutic decision-making.

View Article: PubMed Central - PubMed

Affiliation: Integrated Cancer Genomics Division, Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA, bsalhia@tgen.org.

ABSTRACT
Tumor budding refers to single or small cluster of tumor cells detached from the main tumor mass. In colon cancer high tumor budding is associated with positive lymph nodes and worse prognosis. Therefore, we investigated the value of tumor budding as a predictive feature of lymph node status in breast cancer (BC). Whole tissue sections from 148 surgical resection specimens (SRS) and 99 matched preoperative core biopsies (CB) with invasive BC of no special type were analyzed on one slide stained with pan-cytokeratin. In SRS, the total number of intratumoral (ITB) and peripheral tumor buds (PTB) in ten high-power fields (HPF) were counted. A bud was defined as a single tumor cell or a cluster of up to five tumor cells. High tumor budding equated to scores averaging >4 tumor buds across 10HPFs. In CB high tumor budding was defined as ≥10 buds/HPF. The results were correlated with pathological parameters. In SRS high PTB stratified BC with lymph node metastases (p ≤ 0.03) and lymphatic invasion (p ≤ 0.015). In CB high tumor budding was significantly (p = 0.0063) associated with venous invasion. Pathologists are able, based on morphology, to categorize BC into a high and low risk groups based in part on lymph node status. This risk assessment can be easily performed during routine diagnostics and it is time and cost effective. These results suggest that high PTB is associated with loco-regional metastasis, highlighting the possibility that this tumor feature may help in therapeutic decision-making.

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NST breast cancer with high tumor budding. Overview (×4) of a high PTB (a) and high ITB (c) breast cancer stained with anti-pan-cytokeratin antibody. b and d A high-power field (×40) with more than four tumor buds
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Fig3: NST breast cancer with high tumor budding. Overview (×4) of a high PTB (a) and high ITB (c) breast cancer stained with anti-pan-cytokeratin antibody. b and d A high-power field (×40) with more than four tumor buds

Mentions: In SRS, tumor buds at the invasive front or within the tumor center were scored separately. Invasive tumor front buds are referred to as peripheral tumor buds (PTB) and were scored within ≈1.1 mm (2 × 1 high-power field (HPF) @0.55 mm2) on either direction of the tumor interface. Tumor buds within the center are referred to as intratumoral buds (ITB) (Fig. 2). We used pre-defined criteria for the assessment of tumor buds in accordance with recent publications describing scoring of tumor buds in colon cancer SRS [14] and cut-off criteria in BC [15]. For SRS, 2 pathologists (CT, MT) scored 10 HPF independently and blindly without knowledge of tumor characteristics (e.g., nodal status) and each other’s results. According to a recent report [15], tumors were considered to have high tumor budding if the average number of tumor buds in 10 HPF >4. In contrast, tumors were considered to have low tumor budding if the average number of buds in 10 HPF was ≤4. Examples of high tumor budding are seen in Fig. 3 and examples of low tumor budding are given in Fig. 4.Fig. 2


High tumor budding stratifies breast cancer with metastatic properties.

Salhia B, Trippel M, Pfaltz K, Cihoric N, Grogg A, Lädrach C, Zlobec I, Tapia C - Breast Cancer Res. Treat. (2015)

NST breast cancer with high tumor budding. Overview (×4) of a high PTB (a) and high ITB (c) breast cancer stained with anti-pan-cytokeratin antibody. b and d A high-power field (×40) with more than four tumor buds
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4368849&req=5

Fig3: NST breast cancer with high tumor budding. Overview (×4) of a high PTB (a) and high ITB (c) breast cancer stained with anti-pan-cytokeratin antibody. b and d A high-power field (×40) with more than four tumor buds
Mentions: In SRS, tumor buds at the invasive front or within the tumor center were scored separately. Invasive tumor front buds are referred to as peripheral tumor buds (PTB) and were scored within ≈1.1 mm (2 × 1 high-power field (HPF) @0.55 mm2) on either direction of the tumor interface. Tumor buds within the center are referred to as intratumoral buds (ITB) (Fig. 2). We used pre-defined criteria for the assessment of tumor buds in accordance with recent publications describing scoring of tumor buds in colon cancer SRS [14] and cut-off criteria in BC [15]. For SRS, 2 pathologists (CT, MT) scored 10 HPF independently and blindly without knowledge of tumor characteristics (e.g., nodal status) and each other’s results. According to a recent report [15], tumors were considered to have high tumor budding if the average number of tumor buds in 10 HPF >4. In contrast, tumors were considered to have low tumor budding if the average number of buds in 10 HPF was ≤4. Examples of high tumor budding are seen in Fig. 3 and examples of low tumor budding are given in Fig. 4.Fig. 2

Bottom Line: The results were correlated with pathological parameters.This risk assessment can be easily performed during routine diagnostics and it is time and cost effective.These results suggest that high PTB is associated with loco-regional metastasis, highlighting the possibility that this tumor feature may help in therapeutic decision-making.

View Article: PubMed Central - PubMed

Affiliation: Integrated Cancer Genomics Division, Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA, bsalhia@tgen.org.

ABSTRACT
Tumor budding refers to single or small cluster of tumor cells detached from the main tumor mass. In colon cancer high tumor budding is associated with positive lymph nodes and worse prognosis. Therefore, we investigated the value of tumor budding as a predictive feature of lymph node status in breast cancer (BC). Whole tissue sections from 148 surgical resection specimens (SRS) and 99 matched preoperative core biopsies (CB) with invasive BC of no special type were analyzed on one slide stained with pan-cytokeratin. In SRS, the total number of intratumoral (ITB) and peripheral tumor buds (PTB) in ten high-power fields (HPF) were counted. A bud was defined as a single tumor cell or a cluster of up to five tumor cells. High tumor budding equated to scores averaging >4 tumor buds across 10HPFs. In CB high tumor budding was defined as ≥10 buds/HPF. The results were correlated with pathological parameters. In SRS high PTB stratified BC with lymph node metastases (p ≤ 0.03) and lymphatic invasion (p ≤ 0.015). In CB high tumor budding was significantly (p = 0.0063) associated with venous invasion. Pathologists are able, based on morphology, to categorize BC into a high and low risk groups based in part on lymph node status. This risk assessment can be easily performed during routine diagnostics and it is time and cost effective. These results suggest that high PTB is associated with loco-regional metastasis, highlighting the possibility that this tumor feature may help in therapeutic decision-making.

Show MeSH
Related in: MedlinePlus