Tumor Budding in Invasive Breast Carcinoma: Association With Histopathological Features and Hormone Receptor Status

BackgroundTumor budding (TB), characterized by the presence of isolated tumor cells or small clusters of tumor cells at the invasive front or within the tumor parenchyma, is recognized as a potential histopathological indicator of tumor aggressiveness and metastatic potential.The present study evaluated the extent of TB in invasive breast carcinoma and investigated its association with key histopathological characteristics and hormone receptor status. MethodologyThis prospective observational study included 94 histopathologically confirmed cases of invasive breast carcinoma treated with modified radical mastectomy.TB was evaluated on hematoxylin and eosin (H&E)stained sections and classified as peripheral tumor budding (PTB) and intratumoral tumor budding (iTB), with each categorized as low, intermediate, or high using a study-specific scoring approach adapted from published TB grading methods, rather than a universally validated breast-specific scoring system.Clinicopathological characteristics and immunohistochemical expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2/neu were assessed.Associations between TB and clinicopathological variables were evaluated using the chi-square test, with a p-value <0.05 considered statistically significant. ResultsPTB was categorized as low, intermediate, and high in 28 (29.8%),38 (40.4%), and 28 (29.8%)cases, respectively, whereas iTB was low, intermediate, and high in 34 (36.2%),46 (48.9%), and 14 (14.9%)cases, respectively.PTB was significantly associated with necrosis, lymph node metastasis, and perineural invasion, whereas iTB was significantly associated with necrosis, lymph node metastasis, and lymphovascular invasion (p < 0.05). ConclusionsTB is significantly associated with selected adverse clinicopathological features in invasive breast carcinoma.Its assessment on routine H&E sections provides a simple and potentially cost-effective histopathological adjunct to conventional pathological evaluation.