Tumor budding in preoperative breast biopsies predicts sentinel lymph node metastasis

Area of Science:

• Oncology
• Surgical Pathology
• Breast Cancer Research

Background:

• Sentinel lymph node biopsy (SLNB) is crucial for determining axillary lymph node dissection (ALND) in breast cancer management.
• Preoperative identification of sentinel lymph node metastasis is vital for surgical planning.
• Tumor budding (TB) is a prognostic marker linked to lymph node metastasis in various cancers, including breast cancer.

Purpose of the Study:

• To investigate the predictive role of tumor budding (TB) in preoperative breast biopsies for sentinel lymph node metastasis.
• To assess if TB in needle biopsies can enhance preoperative risk stratification for breast cancer patients undergoing SLNB.

Main Methods:

• Retrospective analysis of 65 breast cancer patients (invasive ductal carcinoma) who underwent preoperative needle biopsy and SLNB.
• Histological reevaluation of biopsy slides, classifying tumor cell clusters of up to four cells as tumor budding (TB).
• Correlation of preoperative TB status with postoperative sentinel lymph node metastasis findings.

Main Results:

• Tumor budding (TB) was present in 36 patients and absent in 29.
• Sentinel lymph node metastasis was significantly more frequent in patients with TB (18/36) compared to those without TB (5/29) (p=0.006).
• No significant difference in median tumor size was observed between TB-positive and TB-negative groups.

Conclusions:

• Evaluating tumor budding in preoperative breast tru-cut specimens is a valuable tool for predicting sentinel lymph node metastasis.
• Incorporating TB assessment with clinical and radiological findings may improve preoperative risk stratification for breast cancer patients.
• This approach can potentially optimize the decision-making process for sentinel lymph node biopsy (SLNB) and subsequent management.