Role of Plasma D-Dimer Levels in Breast Cancer Patients and Its Correlation with Clinical and Histopathological Stage

Abstract

Breast cancer, the most common female malignancy, represents a heterogeneous group of tumors, which presen both varied behaviors and response to therapy. This study was done with an attempt to evaluate the role of D-dimer in patients of carcinoma breast, in predicting lymph node metastasis in carcinoma patients and to look for relationship of these markers with histopathologic parameters. Clinical data was obtained from clinical examination of patients admitted in the Department of Surgery with history of breast lump and confirmed with fine needle aspiration cytology (FNAC). Clinical staging was done using TNM staging. D-dimer level was measured prior to commencement of treatment, i.e., modified radical mastectomy (MRM) or neoadjuvant chemotherapy and finally 6 months after surgery or completion of 6 cycles of chemotherapy. The characteristics of the study population Out of 60 study cases minimum age of the patient being 30 years and maximum being 74 years. Of all histopathologic variables examined, D-dimer levels directly correlated with extent of lymph node involvement and lymphovascular invasion, D-dimer levels correlated strongest with the number of positive lymph nodes, but not with tumor size, estrogen receptor status, and progesterone receptor status. This study clearly shows that plasma D-Dimer levels are elevated in carcinoma breast patients. Increased D-Dimer levels are an important marker of clinical stage, lymphovascular invasion, lymph node involvement, and tumor metastasis.

<p>The Research Progress on the Prognostic Value of the Common Hematological Parameters in Peripheral Venous Blood in Breast Cancer</p>

“…Studies have shown that the level of D-dimer is related to the occurrence of breast cancer, is an independent factor in the prognosis of breast cancer, and is associated with distant metastasis of breast cancer. 24 Levitan and other scholars have pointed out that thromboembolism in cancer patients is 6 times that of normal people. Thromboembolism can lead to hypercoagulability of blood, damage to blood vessels and slow blood flow.…”

Evaluation of treatment for diffuse large B-cell lymphoma using plasma D-dimer levels

“…The release and activation of various tumor-associated coagulation factors, such as tissue factor, fibrin, and fibrinolytic enzymes 20 , can potentiate the coagulation system and trigger a cascade of coagulation reactions through different signaling pathways 21 . Several types of tumors, including lung 8 , prostate 22 , cervical 23 , breast 7 , and colorectal malignancies 11 , exhibit elevated levels of D-dimers, excluding those with clinical thrombosis. The dysregulation of the coagulation system may serve as an early indication of tumor cell proliferation and a significant marker of occult tumors or residual tumor cells that persist in the body after chemotherapy and remain dormant for years 24 .…”

“…Patients with lower D-dimer levels may have inactive tumors and smaller tumor volumes. Elevated plasma D-dimer levels predict an increased risk of tumor recurrence and a poorer prognosis, according to data from a retrospective cohort analysis of patients with epithelial carcinoma of the upper urinary tract by Chen et al D-dimer levels have been shown to be useful in assessing the treatment and prognosis of a wide variety of malignancies 35 , including colorectal and uroepithelial malignancies 11,35 , as well as gastric 9,19,36 , lung 37 , breast 7,25 , cervical cancers 23 , and high-grade musculoskeletal sarcoma 38 .…”

“…It has garnered significant attention in recent years owing to its potential as a sensitive and real-time molecular marker, rapidly eliminated from the body 6 . While prior research has established associations between elevated D-dimer levels and solid tumors like breast 7 , lung 8 , gastric 9 , and colorectal malignancies 10,11 , the specific role of D-dimer in malignant lymphoma has remained a relatively uncharted territory. Moreover, while numerous studies have explored its links to patient prognosis 12,13 , there remains a notable scarcity of research focused on its utility as a marker for evaluating treatment outcomes following standard chemotherapy cycles.…”