ORIGINAL ARTICLE

Tumor Budding in Breast Carcinoma: Relation to E-Cadherin, MMP-9 Expression, and Metastasis Risk

Ni Putu Sriwidyani , Ida Bagus Tjakra Wibawa Manuaba, I Gusti Alit-Artha, I Nyoman Mantik-Astawa

Ni Putu Sriwidyani
Postgraduate Program, Udayana University, Bali-Indonesia. Email: sriwid_yani@gmail.com

Ida Bagus Tjakra Wibawa Manuaba
Faculty of Medicine, Udayana University, Bali-Indonesia Department of Surgery, Faculty of Medicine Udayana University / Sanglah General Hospital, Indonesia

I Gusti Alit-Artha
Faculty of Medicine, Udayana University, Bali-Indonesia

I Nyoman Mantik-Astawa
Faculty of Veterinary Medicine, Udayana University, Bali-Indonesia
Online First: October 22, 2016 | Cite this Article
Sriwidyani, N., Manuaba, I., Alit-Artha, I., Mantik-Astawa, I. 2016. Tumor Budding in Breast Carcinoma: Relation to E-Cadherin, MMP-9 Expression, and Metastasis Risk. Bali Medical Journal 5(3): 497-501. DOI:10.15562/bmj.v5i3.335


Background: Tumor budding is a histopathologic entity refers to small cluster of cancer cells at the invasive edge of tumor. It was assumed that tumor budding is linked to epithelial-mesenchymal transition, an early event in metastasis. Objective: This study aimed to find out the correlation of tumor budding with E-cadherin and MMP-9 expression and risk of metastasis in breast carcinoma. Method: We investigated 35 cases breast carcinoma with metastasis and 35 cases without metastasis. The number of tumor budding was counted in cytokeratin-stained slides with 400x magnification (0.57 mm2). Result: Cut-off point by ROC analysis was 11 and the patient was categorized into low grade (0-10 buds) and high grade (11 or more buds) tumor budding. Inter-observer agreement was good with K value 0.914. Low level of E-cadherin was not significantly correlated with high grade tumor budding (p=0.660), meanwhile high level of MMP-9 was significantly correlated with high grade tumor budding (p=0.001). High grade tumor budding was a significant, independent risk factor of metastasis in breast carcinoma (OR=38.2, 95% CI 7.5-193.7, p<0.001). Conclusion: In conclusion, tumor budding grade is related to level of MMP-9 but has no correlation E-cadherin expression. High grade tumor budding is an independent risk factor of metastasis in breast carcinoma.


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