Nipple adenoma is a rare benign tumor arising from the lactiferous ducts of the nipple and may clinically mimic malignant breast conditions such as Paget’s disease. Accurate diagnosis is often challenging, and histopathological confirmation is essential. A 37-year-old woman presented with a 10-month history of a red tumor on the right nipple accompanied by erosion and bloody nipple discharge. Imaging studies revealed no definite causative lesion; however, a subtle hypoechoic lesion within the nipple was noted on ultrasonography. A punch biopsy demonstrated benign proliferative glandular structures. Surgical excision was performed with complete removal of the nipple and partial resection of the areola. Histopathological examination showed ductal proliferation with a dual epithelial and myoepithelial cell layer without cytologic atypia or invasive features. Immunohistochemical staining for p63 confirmed the presence of myoepithelial cells. The postoperative course was uneventful, and no recurrence was observed at the 6-month follow-up. Nipple adenoma should be considered in patients presenting with nipple lesions. Histopathological and immunohistochemical evaluation is essential for accurate diagnosis and appropriate management, allowing differentiation from malignant conditions and avoidance of overtreatment.
Purpose: Gastric cancer is a major global health issue, especially in advanced stages with metastasis. However, anti-angiogenic treatments such as ramucirumab target vascular endothelial growth factor, yet the exact mechanisms behind hematogenous metastasis remain unclear. This study analyzed RNA sequencing data from TCGA to identify angiogenesis-related genes in metastatic gastric cancer.Methods: Patients were categorized into four metastasis types (non-metastasis, hematogenous, locoregional, and lymphatic) based on clinical data. cBioPortal was used to identify frequently mutated genes across five metastatic cancer studies. RNA sequencing and clinical data were obtained from the TCGA-STAD project. RNA expression levels were compared across metastasis groups using independent-samples t-tests, followed by false discovery rate adjustment for multiple comparisons.Results: RNA expression analysis was performed using a 132-gene analytical panel in the TCGA-STAD cohort. Among the 95-gene angiogenesis/metastasis-related genes represented in this panel, RAF1, ARID1A, ERBB3, FGFR3, BAP1, TSC2, and KDR showed nominal expression differences in comparisons involving the hematogenous metastasis group. None of these differences remained statistically significant after false discovery rate correction.Conclusion: In this exploratory analysis, several candidate genes with prior literature support showed nominal expression differences in comparisons involving hematogenous metastasis in gastric cancer. These findings are hypothesis-generating and require validation in independent cohorts and functional studies.
Purpose: Neoadjuvant chemoradiotherapy (NACRT) followed by esophagectomy is a standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). Pathological response, assessed using tumor regression grade (TRG), is an established prognostic marker; however, evidence regarding its association with the pattern and timing of recurrence remains limited. This study evaluated recurrence patterns, timing of recurrence, and survival outcomes according to pathological tumor response following NACRT and esophagectomy for ESCC.Methods: We retrospectively analyzed 129 patients with ESCC who underwent NACRT followed by radical esophagectomy between January 2013 and June 2023. Pathological response was assessed according to the College of American Pathologists TRG system and categorized as TRG 0 (complete response), TRG 1 (near-complete response), TRG 2 (partial response), or TRG 3 (poor/no response). Recurrence patterns and timing, disease-free survival, and overall survival were compared across TRG categories.Results: Among 129 patients, 33 (25.6%) developed recurrence. Systemic recurrence was the most common pattern (16/33, 48.5%), followed by combined locoregional and systemic recurrence (9/33, 27.3%) and isolated locoregional recurrence (8/33, 24.2%). Patients with TRG 0 had the lowest proportion of isolated locoregional recurrence (16.7%), with systemic and combined recurrence accounting for 50.0% and 33.3%, respectively. In contrast, TRG 3 patients predominantly developed isolated locoregional recurrence (80.0%), with systemic recurrence occurring in 20.0%; all recurrences in this group occurred within 12 months, suggesting poorer local disease control.Conclusion: Poor pathological response was associated with earlier and predominantly locoregional recurrence, whereas favourable pathological response was associated with a greater proportion of systemic recurrence. These findings suggest that pathological tumor response may help inform postoperative risk stratification and guide individualized surveillance strategies in patients with ESCC.
Purpose: Minichromosome maintenance protein 2 (MCM2) is a key regulator of DNA replication and has been implicated in tumor progression. While previous studies have demonstrated its role in lung cancer stem cells (CSCs), its role in breast cancer remains unclear. This study aimed to investigate whether MCM2 regulates CSCs and epithelial-mesenchymal transition (EMT) in breast cancer.Methods: MCM2 expression and its prognostic significance were analyzed using public breast cancer datasets. MDA-MB-231 breast cancer cells were transfected with MCM2-specific small interfering RNA. CSC-associated markers and EMT-related proteins were evaluated by Western blotting. Sphere formation, migration, and invasion assays were performed to assess CSC properties and metastatic potential.Results: MCM2 expression was significantly elevated in breast cancer tissues and correlated with poor prognosis. Knockdown of MCM2 reduced the expression of CSC-associated markers, including ALDH1A1, Sox2, Oct4, and CD44. Functional assays showed that MCM2 suppression significantly decreased sphere-forming capacity, indicating impaired CSC properties. In addition, MCM2 knockdown increased E-cadherin expression while decreasing N-cadherin, Slug, Twist, and ZEB1 expression, suggesting inhibition of EMT. Migration and invasion abilities were also markedly reduced.Conclusion: Suppression of MCM2 was associated with reduced CSC and EMT-related phenotypes in MDA-MB-231 breast cancer cells.
Adenoid cystic carcinoma of the breast (ACCB) is a rare special-type carcinoma, accounting for <0.1% of breast malignancies. Despite its frequent triple-negative phenotype, ACCB typically demonstrates indolent behavior and a favorable prognosis. Owing to its rarity and overlapping radiologic and histopathological features, accurate diagnosis can be challenging. We retrospectively analyzed three cases of histologically confirmed primary ACCB diagnosed at a tertiary care center. Clinical presentation, imaging findings, histomorphology, immunohistochemistry, treatment, and follow-up data were reviewed. The patients were women aged 42–58 years, all presenting with a breast lump; one case showed Paget-like nipple changes. Imaging findings varied from benign-appearing cysts to Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions. Histology revealed classic biphasic morphology with tubular, cribriform, and focal solid patterns with perineural invasion noted in one. Tumor cells consistently expressed c-KIT (CD117) and myoepithelial markers (p63/S100), lacked HER2 (human epidermal growth factor receptor 2) expression, and showed variable hormone receptor status. All tumors were low-grade (grade 1), ≤2 cm, with negative sentinel lymph nodes where assessed. Surgical excision with clear margins was performed in all cases, with adjuvant radiotherapy in one patient. No recurrence or metastasis was observed on follow-up. Primary ACCB requires accurate recognition to prevent misdiagnosis and overtreatment.
Purpose: Gastric cancer is a heterogeneous disease in which cancer stem cell-associated properties may contribute to tumor heterogeneity and progression. This study aimed to establish paired normal and tumor gastric organoids, characterize stemness-related gene expression, and explore its association with organoid formation.Methods: Normal and tumor tissues were obtained from 12 patients with advanced gastric cancer. A total of 28 independent organoid cultures were established from 24 tissue specimens (12 normal and 12 tumor), with selected serial strip specimens divided into segments and cultured independently. Expression of stemness-associated markers (AQP5, CD44, ALDH1A, STMN1, and SOX2) was evaluated by quantitative real-time polymerase chain reaction and compared according to tissue origin, histological subtype, and organoid formation status.Results: Normal organoids tended to exhibit higher CD44 expression, whereas tumor-derived organoids showed relatively higher ALDH1A expression, although these differences were not statistically significant. Margin-derived normal organoids tended to show higher expression of multiple stemness-associated markers than those derived from tissue adjacent to tumors. Diffuse-type organoids tended to show higher CD44 expression, whereas AQP5, ALDH1A, STMN1, and SOX2 tended to be higher in intestinal-type organoids. Organoid-forming cultures consistently showed higher stemness-marker expression than non-forming cultures, particularly among tumor-derived organoids.Conclusion: Stemness-associated gene expression varied according to tissue origin, histological subtype, and organoid formation status. Higher stemness-marker expression in organoid-forming cultures suggests a potential association between stemness-related programs and organoid-forming capacity.
PURPOSE:This study aimed to compare clinical, nutritional, and endoscopic outcomes among Roux-en-Y (RY), uncut Roux-en-Y (uRY), and Billroth II with Braun anastomosis (BB) reconstruction methods in gastric cancer patients after distal gastrectomy. METHODS:This retrospective study analyzed gastric cancer patients who underwent laparoscopic distal gastrectomy between January 2018 and December 2022, categorized into RY, uRY, and BB. Demographic, pathological, clinical, nutritional, and endoscopic data were collected over 24 months. Endoscopic outcomes were assessed using the RGB scoring system, evaluating residual food, gastritis, and bile reflux. Delayed gastric emptying was defined by clinical and imaging criteria. Multivariable linear regression was performed to identify relevant factors associated with 24 months RGB scores and mixed linear model was applied to assess the time interaction. RESULTS:A total of 221 patients were included (70 RY, 75 uRY, 76 BB). Baseline characteristics, perioperative and nutritional outcomes were comparable among groups. The uRY group showed less weight loss at 3 months (5.9%, P<0.05) but did not differ in other studied periods. The RY group had the lowest RGB scores at all time points, while BB showed the highest and progressively worsening scores. Regression model showed that BB and uRY was related to increase 24 month RGB score. BB showed increased RGB score while RY was stable in time and uRY showed intermediate change in the mixed linear model (P<0.05). CONCLUSION:The nutritional clinical outcomes were comparable between the reconstructions. RY reconstruction demonstrated favorable endoscopic outcomes, while BB was associated with higher RGB scores in time.
Autophagy process is important in the removal of damaged organelles following radiation interaction. Autophagy maintains stability or balance between intracellular environments at the cellular level. High linear energy transfer radiation is a complex and under-researched field of cancer and radiation biology. In-depth investigation in this area is necessary because autophagy has both protective and detrimental effects on cells, and the specific response can vary depending on factors like the type of radiation, the cell type, and the stage of cancer. Ionizing radiation exposure caused significant alterations in the autophagy genes (ATG3, ATG5, ATG7, ATG8, ATG12). Autophagy blocker could prevent cells from autophagic cell death in response to high linear energy transfer radiation. We have outlined how autophagy can reverse complications of serious diseases in tumor cells and tumor microenvironment, which will contribute to a new direction for better treatment of diseases.
PURPOSE:To evaluate clinicopathological characteristics and long-term outcomes of patients with positive resection margins identified during intraoperative frozen section (IFS) in gastric cancer surgery. METHODS:A retrospective analysis of 5,894 patients who underwent gastrectomy between May 2005 and December 2023. Among 207 patients with positive IFS margins, 121 were included after exclusion criteria. Additional resection was performed in 87 patients, while 34 received no further resection. Patients were divided into survivor group and non-survivor group for comparison. Patients' demographics, perioperative and survival outcomes were analyzed. RESULTS:R0 resection was achieved in 100 patients (82.6%), while 21 patients (17.4%) had R1 resection. During follow-up, 76 patients survived and 45 died. Five-year overall survival rates were 95.7% for stage I, 56.6% for stage II, and 32.9% for stage III. The non-survivor group showed significantly higher rates of R1 resection (35.6% vs. 6.6%, P<0.001), advanced stage disease (82.2% vs. 40.8%, P<0.001), and pathological high-risk features. In multivariate analysis, TNM stage and R0 resection status were the most significant prognostic factors. Proximal margin length did not correlate with survival outcomes. CONCLUSION:TNM stage and achieving R0 resection were the most important prognostic factors in patients with positive IFS margins. R0 resection had greater survival impact in low-risk groups, while R1 resection was associated with poor outcomes regardless of stage, emphasizing the importance of complete tumor removal when technically feasible.
Primary Ewing sarcoma of the uterine cervix is an exceptionally rare and aggressive malignancy, with only 34 cases reported in the literature. Early recognition and prompt multimodal treatment are essential due to its poor prognosis. We report a case involving a 32-year-old multiparous woman who presented with foul-smelling vaginal discharge and irregular bleeding. Clinical examination revealed a 6×6 cm friable cervical mass extending into the upper vagina. Imaging demonstrated an FDG-avid cervical mass with regional lymphadenopathy. Histopathological analysis, supported by immunohistochemistry and fluorescence in situ hybridization, confirmed Ewing sarcoma with EWSR1 gene rearrangement. The patient received neoadjuvant chemotherapy with VDC (vincristine, doxorubicin, cyclophosphamide) and PIE (cisplatin, ifosfamide, etoposide) regimens, followed by surgical resection, adjuvant chemotherapy, and pelvic radiotherapy. Although initial disease control was achieved, the patient experienced disease recurrence with distant metastases after a 7-month disease-free interval and succumbed to the illness 9 months after diagnosis. This case underscores the importance of including Ewing sarcoma in the differential diagnosis of rapidly growing cervical tumors, particularly in young women. A multidisciplinary approach involving early molecular diagnostics and aggressive combined therapy is critical to improving clinical outcomes in such rare and aggressive cases.
PURPOSE:In Korea, the Health Insurance Review and Assessment Service (HIRA) mandates patient participation in outpatient multidisciplinary team (MDT) meetings as part of national cancer quality assessment. However, the necessity of involving patients and families in MDT discussions remains debatable. This study explored international expert perspectives on patient participation in gastric cancer MDTs. METHODS:A cross-national expert survey was conducted in September 2021 among 15 gastric cancer specialists from Korea, China, Japan, Singapore, and the United States. The survey assessed the frequency of patient and family member attendance, perceived pros and cons, and preferences regarding mandatory versus selective involvement. Additionally, MDT structures and policies were reviewed by countries. RESULTS:Most respondents reported that patients and families rarely or never attend MDT meetings: nine stated that patients are never included, three reported "usually not," and three indicated "sometimes." None consistently included patients. The most cited benefits were sharing opinions with patients and families simultaneously, followed by improved explanation of treatment and legal protection. Major concerns included hindered discussion, inefficiency, and logistical challenges. Only four respondents supported routine participation, while 11 favored case-dependent involvement. CONCLUSION:International experts do not widely support mandatory patient participation in MDT meetings. A flexible approach that allows MDTs to operate with or without patient involvement may better reflect actual clinical practice.
Inflammatory myofibroblastic tumors (IMTs) of the duodenum are exceptionally uncommon, and their epidemiologic and clinical characteristics remain poorly defined because of the limited number of reported cases. We previously reported a case of duodenal IMT in the Korean Journal of Gastroenterology in 2018, with follow-up data available only up to 12 months. IMTs typically behave in a benign manner, but they may occasionally demonstrate local invasiveness and recurrence; therefore, achieving complete surgical excision is crucial, followed by long-term surveillance. In the present manuscript, we provide a subsequent long-term follow-up report of the same patient, offering an extended 88-month postoperative course and additional radiologic and pathologic details not included in the earlier publication. This follow-up report highlights the long-term benign behavior of the tumor despite positive surgical margins and anaplastic lymphoma kinase (ALK)-negative immunohistochemistry, contributing meaningful information to the scarce literature on adult duodenal IMTs.
Purpose This systematic review and meta-analysis aimed to examine the relationship between ovarian and colorectal cancer, with a particular focus on the standardized incidence ratio (SIR). Methods A comprehensive search was conducted across multiple databases, including Scopus, Web of Science, PubMed, and Google Scholar. A total of 20 studies were included in the final analysis. Results The results indicated that women with ovarian cancer had a significantly higher incidence of colorectal cancer (SIR, 1.69; 95% confidence interval [CI], 1.39–1.98), with an increased risk for both colon (SIR, 1.57; 95% CI, 1.14–1.99) and rectal cancers (SIR, 1.58; 95% CI, 1.38–1.78). Subgroup analysis of borderline ovarian tumor revealed an SIR for colorectal cancer of 1.27 (95% CI, 0.99–1.55), with a significant risk in the serous subtype (SIR, 1.38; 95% CI, 1.09–1.67). Conversely, studies examining ovarian cancer in women diagnosed with colorectal cancer showed an SIR of 1.48 (95% CI, 1.17–1.79). Specifically, women with colon cancer had a higher incidence of ovarian cancer (SIR, 1.64; 95% CI, 1.25–2.03), while women with rectal cancer showed a decreased risk (SIR, 0.88; 95% CI, 0.77–0.99). The results underscore the potential bidirectional relationship between ovarian and colorectal cancers, which may be influenced by genetic predispositions. Conclusion Future advanced genetic studies are needed to better understand the underlying molecular mechanisms. Additionally, the results emphasize the importance of careful cancer surveillance and early detection strategies for women with a history of either ovarian cancer or colorectal cancer.
PURPOSE:This study aimed to analyze the benefit of neoadjuvant chemoradiation therapy (nCRT) versus adjuvant chemotherapy alone after surgery without nCRT on oncologic and perioperative outcomes of patients with extremely low rectal cancer requiring abdominoperineal resection (APR) when initially diagnosed. METHODS:Between March 2001 and December 2018, 88 patients who underwent APR for low rectal adenocarcinoma (anal verge < 4 cm) with clinical stage II and III (clinical T3/4, N -/+) were retrieved from a retrospective database. Sixty-eight patients received adjuvant chemotherapy alone after APR without nCRT, and 20 patients received nCRT before APR. RESULTS:Median follow-up was 59.7 months. The 5-year disease-free survival rate was significantly higher in the nCRT group compared to in chemotherapy alone group (85.5% vs. 58.2%, P= 0.022). The 5-year overall survival rate was also significantly higher in nCRT group compared to in chemotherapy alone group (79.6% vs. 60.0%, P= 0.042). The total recurrence rate was 45.6% in chemotherapy alone group and 15.0% in the nCRT group (P= 0.010). There was no significant difference in circumferential resection margin positive rate, postoperative morbidity, and mortality between the two groups. CONCLUSION:Based on present data, the oncologic outcomes are better in nCRT compared to adjuvant chemotherapy alone after surgery without nCRT in patient with extremely low rectal cancer requiring APR initially diagnosed, even if curative resection is possible at first.
PURPOSE:Multiple primary tumors arising in the same individual pose challenges for precision oncology, particularly in the context of hereditary cancer syndromes such as Lynch syndrome. While these tumors may originate from a shared germline predisposition, it remains unclear whether they also share somatic alterations that could be therapeutically exploited. This study aimed to characterize the extent of somatic genomic overlap between synchronous or metachronous gastric and colorectal cancers within young Korean patients. METHODS:Nineteen patients diagnosed with both gastric and colorectal cancers before age 55 underwent whole exome sequencing of formalin-fixed paraffin-embedded tumor tissues. Microsatellite instability (MSI) status was determined, and germline mismatch repair (MMR) variants were assessed to identify Lynch syndrome cases. Somatic mutations, mutational signatures, and copy number alterations were analyzed to quantify intertumoral genomic similarity within individual patients. RESULTS:Among the 37 tumors analyzed, 36.8% of gastric and 44.4% of colorectal cancers were MSI-high. Germline pathogenic MMR variants were identified in seven patients. Despite shared hypermutated phenotypes, the proportion of overlapping somatic mutations between paired tumors was consistently low (< 5%). Mutational signatures varied by MSI status and included SBS1/5 (aging) and SBS15 (MMR deficiency). Notably, one non-Lynch patient exhibited MYC amplification in both tumors, confirmed by fluorescence in situ hybridization. CONCLUSION:Even in patients with shared germline predisposition, primary tumors arising in different organs demonstrate substantial genomic divergence. These findings suggest that organ-specific selective pressures drive independent tumor evolution, underscoring the need for individualized molecular profiling and therapeutic targeting in cases of multiple primary cancers.
Approximately 3% to 5% of individuals with oncogenic rearrangements in the anaplastic lymphoma kinase (ALK) gene develop non-small cell lung cancer (NSCLC). Brigatinib, a potent next-generation ALK tyrosine kinase inhibitor (TKI), has demonstrated significant systemic and intracranial responses, as well as improved progression-free survival, with an acceptable safety profile. According to European Society for Medical Oncology guidelines patients with ALK translocation and performance status 0-3 can be offered 1st line treatment with TKI (brigatinib, alectinib, or lorlatinib). To our knowledge, this is the first reported case of cystic or bullous changes in the lungs following incremental dosing of brigatinib. Here, we describe a 37-year-old male, a never-smoker, who developed progressively diffuse cystic changes in the lung parenchyma while receiving brigatinib treatment for NSCLC with intrapulmonary metastases. Clinicians should remain vigilant for this potential atypical pulmonary adverse effect, including the possibility of cystic or bullous transformations in the lung parenchyma.
PURPOSE:Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity associated with oxaliplatin-based chemotherapy in gastric cancer patients. Recent studies suggest that high-dose intravenous selenium may exert neuroprotective effects in patients receiving platinum-based chemotherapy. METHODS:This pilot study analyzed patients with stage III gastric adenocarcinoma who underwent gastrectomy between January and December 2024. A total of 28 patients receiving adjuvant capecitabine plus oxaliplatin (XELOX) chemotherapy were included and divided into two groups: one receiving chemotherapy alone (non-selenium: n= 17) and the other receiving an intravenous injection of selenium (2,000 µg/day) before chemotherapy (selenium: n= 11). CIPN severity was assessed after the first chemotherapy cycle and at the completion of chemotherapy using standardized grading criteria. RESULTS:Baseline clinicopathological characteristics, including age, sex, body mass index, preoperative comorbidities, extent of resection, operation time, and hospital stay, were comparable between groups. No adverse events related to high-dose selenium administration were observed. There were no significant differences in chemotherapy-related adverse events, such as hand-foot syndrome, nausea, vomiting, diarrhea, and loss of appetite, between the two groups. While CIPN severity was similar between groups after the first chemotherapy cycle, by the end of chemotherapy, the selenium group exhibited significantly lower paresthesia severity compared to the non-selenium group (P < 0.0001). CONCLUSION:High-dose intravenous selenium appears to be a safe and potentially effective intervention for reducing paresthesia associated with oxaliplatin-based chemotherapy. Further large-scale prospective studies are warranted to validate these findings and establish optimal dosing guidelines.
Cancer treatment has undergone significant transformation with the emergence of molecularly targeted drugs, aiming to exploit specific vulnerabilities within cancer cells while sparing normal tissues. One critical aspect of this approach is the identification of druggable targets, proteins or pathways that can be modulated by pharmacological agents to inhibit tumor growth or metastasis. The metastasis-associated protein 1 (MTA1) has emerged as a promising druggable target due to its multifaceted roles in cancer progression, including regulation of gene expression, chromatin remodeling, and promotion of epithelial-mesenchymal transition. This abstract provides an overview of the current landscape of MTA1 as a druggable target in cancer therapy, highlighting its diverse functions across different malignancies and its potential as a predictive biomarker for therapeutic response. Finally, it explores future directions and novel strategies for exploiting MTA1 inhibition in precision oncology. Overall, understanding the druggable potential of MTA1 offers new avenues for the development of innovative cancer treatments with improved efficacy and reduced toxicity, ultimately leading to better clinical outcomes for cancer patients.
This article presents two cases of extrahepatic portal vein anomalies that can be challenging during lymph node (LN) dissection in gastric cancer surgery. The first case was a participant for a clinical trial assessing the completeness of D2 LN dissection. The trial utilized near-infrared (NIR) lymphangiography with indocyanine green only after completing dissection of a certain topological LN station to detect any residual lymphatic tissue. However, the patient was excluded from the trial due to an unexpected extrahepatic portal vein confluence anomaly and aberrant common hepatic artery. Consequently, continuous lymphatic navigation with NIR imaging was utilized for remaining surgery. The second case featured a patient with an anteriorly positioned splenic vein, hindering LN dissection along the left gastric artery. Preoperative identification of great vessel anomalies around the stomach is critical to prevent life-threatening complications during LN dissection in gastric cancer surgery. Augmented imaging technology can be a valuable tool in ensuring oncologic safety and precision.
Purpose Breast cancer is one of the most common cancers globally, with an increasing incidence rate. It is a heterogeneous disease, and early metastasis remains a challenge. Tumor budding, defined as single tumor cells or small clusters at the invasive front, has been suggested as a prognostic marker in various cancers, including breast cancer. This study aims to evaluate tumor budding in invasive breast carcinoma using the International Tumor Budding Consensus Conference (ITBCC) scoring system and explore its association with pathological characteristics and prognosis. Methods A retrospective study was conducted on 100 mastectomy specimens of histopathologically confirmed invasive breast carcinoma, excluding cases that underwent chemotherapy or radiotherapy. Tumor budding was classified as low, intermediate, or high based on the ITBCC scoring method, and associations with clinicopathological features were analyzed using appropriate statistical tests. Results Tumor budding was classified as high in 52% of cases. A significant association was found between high tumor budding and higher tumor grade (P<0.001), negative estrogen receptor and progesterone receptor status (P<0.001), positive HER2neu status (P=0.003), and high Ki-67 levels (P<0.001). High tumor budding was also linked to higher T stage, and dermal lymphovascular invasion (P=0.001). Our findings support previous studies showing that high tumor budding is associated with poor prognostic factors such as higher tumor grade, negative hormone receptor status, and higher T stage. Conclusion Tumor budding is a potential prognostic marker in breast cancer, associated with more aggressive tumor characteristics.
