1.Tumor budding in invasive breast carcinoma and its association with clinicopathological parameters: an experience from a tertiary care center in India
Asmita SHAH ; Shaivy MALIK ; Adil Aziz KHAN ; Charanjeet AHLUWALIA
Korean Journal of Clinical Oncology 2025;21(1):13-19
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.
2.Tumor budding in invasive breast carcinoma and its association with clinicopathological parameters: an experience from a tertiary care center in India
Asmita SHAH ; Shaivy MALIK ; Adil Aziz KHAN ; Charanjeet AHLUWALIA
Korean Journal of Clinical Oncology 2025;21(1):13-19
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.
3.Microangiopathic Hemolytic Anemia: A Rare Complication of Acute Pancreatitis
Syedda AYESHA ; Masood Muhammad KARIM ; Maria ALI ; Abdul Hadi SHAHID ; Salman Naseem ADIL
The Korean Journal of Gastroenterology 2025;85(1):73-77
Microangiopathic hemolytic anemia (MAHA) is a rare subtype of hemolytic anemia characterized by elevated hemolytic markers and red blood cell destruction. Though uncommon, MAHA can occur as a complication of acute pancreatitis because of the associated inflammatory response. Patients with MAHA secondary to pancreatitis show favorable outcomes when treated with plasma exchange.This paper presents the case of a patient diagnosed with acute pancreatitis-induced hemolytic anemia and thrombocytopenia, who was managed successfully with plasma exchange, steroids, and rituximab. Clinicians should maintain a high index of suspicion in patients with acute pancreatitis who present with anemia, thrombocytopenia, and schistocytes on peripheral smears, even in the absence of end-organ injuries and with normal ADAMTS13 activity. The early initiation of plasmapheresis can be lifesaving. The timely introduction of rituximab in cases where plasma exchange and steroids are insufficient, despite the ADAMTS13 activity status, may lead to better outcomes.
4.Microangiopathic Hemolytic Anemia: A Rare Complication of Acute Pancreatitis
Syedda AYESHA ; Masood Muhammad KARIM ; Maria ALI ; Abdul Hadi SHAHID ; Salman Naseem ADIL
The Korean Journal of Gastroenterology 2025;85(1):73-77
Microangiopathic hemolytic anemia (MAHA) is a rare subtype of hemolytic anemia characterized by elevated hemolytic markers and red blood cell destruction. Though uncommon, MAHA can occur as a complication of acute pancreatitis because of the associated inflammatory response. Patients with MAHA secondary to pancreatitis show favorable outcomes when treated with plasma exchange.This paper presents the case of a patient diagnosed with acute pancreatitis-induced hemolytic anemia and thrombocytopenia, who was managed successfully with plasma exchange, steroids, and rituximab. Clinicians should maintain a high index of suspicion in patients with acute pancreatitis who present with anemia, thrombocytopenia, and schistocytes on peripheral smears, even in the absence of end-organ injuries and with normal ADAMTS13 activity. The early initiation of plasmapheresis can be lifesaving. The timely introduction of rituximab in cases where plasma exchange and steroids are insufficient, despite the ADAMTS13 activity status, may lead to better outcomes.
5.Microangiopathic Hemolytic Anemia: A Rare Complication of Acute Pancreatitis
Syedda AYESHA ; Masood Muhammad KARIM ; Maria ALI ; Abdul Hadi SHAHID ; Salman Naseem ADIL
The Korean Journal of Gastroenterology 2025;85(1):73-77
Microangiopathic hemolytic anemia (MAHA) is a rare subtype of hemolytic anemia characterized by elevated hemolytic markers and red blood cell destruction. Though uncommon, MAHA can occur as a complication of acute pancreatitis because of the associated inflammatory response. Patients with MAHA secondary to pancreatitis show favorable outcomes when treated with plasma exchange.This paper presents the case of a patient diagnosed with acute pancreatitis-induced hemolytic anemia and thrombocytopenia, who was managed successfully with plasma exchange, steroids, and rituximab. Clinicians should maintain a high index of suspicion in patients with acute pancreatitis who present with anemia, thrombocytopenia, and schistocytes on peripheral smears, even in the absence of end-organ injuries and with normal ADAMTS13 activity. The early initiation of plasmapheresis can be lifesaving. The timely introduction of rituximab in cases where plasma exchange and steroids are insufficient, despite the ADAMTS13 activity status, may lead to better outcomes.
6.Tumor budding in invasive breast carcinoma and its association with clinicopathological parameters: an experience from a tertiary care center in India
Asmita SHAH ; Shaivy MALIK ; Adil Aziz KHAN ; Charanjeet AHLUWALIA
Korean Journal of Clinical Oncology 2025;21(1):13-19
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.
7.Microangiopathic Hemolytic Anemia: A Rare Complication of Acute Pancreatitis
Syedda AYESHA ; Masood Muhammad KARIM ; Maria ALI ; Abdul Hadi SHAHID ; Salman Naseem ADIL
The Korean Journal of Gastroenterology 2025;85(1):73-77
Microangiopathic hemolytic anemia (MAHA) is a rare subtype of hemolytic anemia characterized by elevated hemolytic markers and red blood cell destruction. Though uncommon, MAHA can occur as a complication of acute pancreatitis because of the associated inflammatory response. Patients with MAHA secondary to pancreatitis show favorable outcomes when treated with plasma exchange.This paper presents the case of a patient diagnosed with acute pancreatitis-induced hemolytic anemia and thrombocytopenia, who was managed successfully with plasma exchange, steroids, and rituximab. Clinicians should maintain a high index of suspicion in patients with acute pancreatitis who present with anemia, thrombocytopenia, and schistocytes on peripheral smears, even in the absence of end-organ injuries and with normal ADAMTS13 activity. The early initiation of plasmapheresis can be lifesaving. The timely introduction of rituximab in cases where plasma exchange and steroids are insufficient, despite the ADAMTS13 activity status, may lead to better outcomes.
8.Tumor budding in invasive breast carcinoma and its association with clinicopathological parameters: an experience from a tertiary care center in India
Asmita SHAH ; Shaivy MALIK ; Adil Aziz KHAN ; Charanjeet AHLUWALIA
Korean Journal of Clinical Oncology 2025;21(1):13-19
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.
9.Microangiopathic Hemolytic Anemia: A Rare Complication of Acute Pancreatitis
Syedda AYESHA ; Masood Muhammad KARIM ; Maria ALI ; Abdul Hadi SHAHID ; Salman Naseem ADIL
The Korean Journal of Gastroenterology 2025;85(1):73-77
Microangiopathic hemolytic anemia (MAHA) is a rare subtype of hemolytic anemia characterized by elevated hemolytic markers and red blood cell destruction. Though uncommon, MAHA can occur as a complication of acute pancreatitis because of the associated inflammatory response. Patients with MAHA secondary to pancreatitis show favorable outcomes when treated with plasma exchange.This paper presents the case of a patient diagnosed with acute pancreatitis-induced hemolytic anemia and thrombocytopenia, who was managed successfully with plasma exchange, steroids, and rituximab. Clinicians should maintain a high index of suspicion in patients with acute pancreatitis who present with anemia, thrombocytopenia, and schistocytes on peripheral smears, even in the absence of end-organ injuries and with normal ADAMTS13 activity. The early initiation of plasmapheresis can be lifesaving. The timely introduction of rituximab in cases where plasma exchange and steroids are insufficient, despite the ADAMTS13 activity status, may lead to better outcomes.
10.Exploring the clinicopathological parameters of HER2 low breast cancers: insights from a retrospective cohort study
Sana AHUJA ; Adil Aziz KHAN ; Kiruthikasri G ; Sufian ZAHEER
Korean Journal of Clinical Oncology 2024;20(2):79-83
Purpose:
Breast cancer subtypes are delineated by human epidermal growth factor receptor 2 (HER2) expression, pivotal in treatment selection. HER2-positive tumors typically respond to targeted therapies, whereas HER2-negative tumors lack HER2 overexpression. However, a subset exhibits low HER2 expression without amplification, termed HER2 low breast cancer. Despite being distinct, its clinicopathological characteristics and therapeutic implications remain less understood.
Methods:
A retrospective cohort study was conducted on histologically confirmed breast cancer cases from January 2022 to December 2023. Clinicopathological data including age, tumor size, nodal involvement, and hormone receptor status were collected. Immunohistochemistry categorized tumors into luminal, triple-negative, and HER2-enriched subtypes. HER2 expression was re-evaluated, classifying tumors into HER2 low and HER2-negative based on staining intensity and amplification status. Statistical analysis was performed using SPSS software.
Results:
Seventy female patients with breast cancer were included, exhibiting diverse clinicopathological features. HER2 low tumors (40%) were significantly associated with higher tumor stage (P=0.03), nodal involvement (P=0.01), and positive androgen receptor expression (P=0.01). Subgroup analysis revealed HER2 low hormone receptor-positive cases (78.6%) were associated with higher tumor stage (P=0.01) and nodal involvement (P=0.01), while HER2 low triple-negative cases (21.4%) demonstrated distinct characteristics such as higher histological grade (P=0.02).
Conclusion
This study underscores the complexity of HER2 low breast cancer and its implications for clinical management, emphasizing the need for personalized treatment strategies. It provides insights into the clinicopathological parameters of HER2 low breast cancers, highlighting their diverse characteristics and clinical implications.

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