Association of Plasma D-Dimer with Histopathological Grade and Stage of Breast Cancer

Abstract

Background: Breast cancer remains the most common cancer and the leading cause of cancer-related mortality among women globally. Coagulation abnormalities, including elevated plasma D-dimer levels, are frequently associated with cancer progression. Plasma D-dimer is a degradation product of fibrin and its elevation indicates increased fibrinolysis and hemostasis activation. This study evaluates the association of plasma D-dimer levels with histopathological grading and staging in breast cancer patients.
Objective: To assess the correlation between plasma D-dimer levels and the histopathological grade and stage of breast cancer.
Materials and Methods: This cross-sectional descriptive study was conducted at the Department of Pathology, Mymensingh Medical College, over a 24-month period. Venous blood samples were collected preoperatively from 86 female patients diagnosed with breast cancer. Plasma D-dimer levels were measured using immunoassays. Tumor specimens were examined histologically, graded using the Scarff-Bloom-Richardson system, and staged according to the TNM classification. Data 
were analyzed using SPSS software.
Results: The mean age of the patients was 49.57 ± 9.96 years. Plasma D-dimer levels ≥0.50 µg/ml were found in 63.9% of patients. A statistically significant increase in D-dimer levels was observed with larger tumor sizes (T1–T4). Elevated D-dimer levels were also associated with lymph node 
metastasis and lymphovascular invasion, but the association with histopathological grade was not statistically significant. The sensitivity and specificity of a D-dimer cutoff value of 0.52 µg/ml for predicting lymph node metastasis were 85.7% and 87.0%, respectively.
Conclusion: Plasma D-dimer levels were significantly associated with tumor size and lymph node involvement in breast cancer. Although there was no significant correlation with histopathological grade, elevated D-dimer levels could be a useful marker for assessing disease progression, particu
larly in relation to lymph node metastasis. Further studies with larger sample sizes are needed to explore its potential as a prognostic biomarker.

J Shaheed Suhrawardy Med Coll 2025; 17(1): 78-83