The Prognostic Value of Tumor Budding in Breast Biopsies and its Relationship with Survival: A Cross Sectional Study

Abstract: Background: In 1954 Imai described Tumor Budding (TB), as a tumor sprouting at the invasive tumor front of colorectal carcinomas. TB is associated with poor prognosis. TB has prognostic importance in invasive ductal carcinoma of the breast. Objective: The present study aims to examine TB in breast needle core biopsy specimens with invasive ductal type carcinoma, and its relationship with other clinicopathological parameters and overall survival. Materials and Methods: From February 2015 to December 2022, patients who had undergone breast carcinoma surgery at the Bolu Abant Izzet Baysal Training and Research Hospital and had preoperative needle core biopsies at the same center were retrospectively analyzed. Needle core biopsy slides were re-evaluated for TB. Tumor size, and nodal status, were retrieved from pathology reports. Overall survival was considered. Analysis of the data was done with statistical software (SPSS 18.0 for Windows, IBM Inc., Chicago, IL, USA). Results: 122 patients were enrolled in the study. The mean age of the study and control groups were 55±12 years and 54±11 years, respectively. TB was identified in 68 (55%) patients; the rest 54 (45%) patients didn’t have any TB. The median value of the metastatic axillary lymph node in the TB absent group was 0 (0-51); in the TB group was 1 (0-21), and this was statistically significant (p=0.03). Lymphovascular invasion was detected in 33 patients (48.5%) in the TB present group and in 14 patients (25.9%) in the TB absent group. That was statistically significant (p=0.01). In the overall survival analysis, mean survival times were lower in the TB group compared to the TB absent group, but it was not statistically significant (p=0.33). Conclusion: In conclusion, tumor budding is a robust prognostic indicator; therefore, assessing tumor budding especially in core needle biopsy specimens will be very helpful for individual treatment options.