Plasma D-Dimer Levels Correlated With Advanced Breast Carcinoma in Female Patients: A Prospective Study at Baghdad Teaching Hospital
AbstractAdvanced breast cancer is a common disease among female gender in the world. There is a correlation between cancer and hypercoagulation. In a cancer state, there is an increase in the level of cross-linked fibrin degradation product (d-dimer) which indicates systemic activation of fibrinolysis and hemostasis. So, there is a relation between increase d-dimer value and advanced breast disease. To study the relation between preoperative plasma d-dimer level and tumor extension, choose the proper option of treatment, and to decrease morbidity and mortality in patients with breast carcinoma, a prospective study (cohort study) was done at Baghdad teaching hospital (department of surgery) from Jan 2014 to Jan 2016. Seventy patients were categorized into two equal groups, group one with breast carcinoma, and group two with benign breast tumor. Plasma d-dimer levels were compared for each group and in relation to (tumor size, stage, grade, lymphovascular invasion, and lymph nodes involvement). The d-dimer level was normal in group two (<0.25 mg/l) and high in group one in other words, the d-dimer level was increasing in advanced breast carcinoma group with enlarged tumor size, higher stage and grade, lymphovascular invasion and lymph nodes’ involvement. Plasma d-dimer levels were a good prognostic factor in breast carcinoma especially in advanced breast carcinoma, and it could be considered a factor for clinical stage progression lymphovascular invasion, and metastasis.
Cabuk D1, Basaran G, Teomete M, Dane F, Korkmaz T, Seber S, ., et al. Clinical outcome of Turkish metastatic breast cancer patients with currently available treatment modalities--single center experience. Asian Pac J Cancer Prev2014; 15: 117-22.
Turgut K, Birsen Y, Seher B, Celasun, MM, Seker N, Babacan. The prognostic value of high pretreatment plasma d-dimer levels in non-metastatic breast cancer patients with absence of venous thromboembolism. International Journal of Hematology and Oncology 2016; 26(3):
Dvorak HF1, Brown LF, Detmar M, Dvorak AM., .Vascular permeability factor/vascular endothelial growth factor, microvascular hyperpermeability, and angiogenesis. Am J Pathol 1995; 146: 1029-39.
Knowlson L1, Bacchu S, Paneesha S, McManus A, Randall K, Rose P., . Elevated D-dimers are also a marker of underlying malignancy and increased mortality in the absence of venous thromboembolism. J Clin Pathol 2010; 63: 818-22.
Falanga A, Rickles FR. Pathophysiology of the thrombophilic state in cancer patient. Semin Thromb Hemost 1999; 25: 173-82.
Green D, Maliekel K, SushkoE, Akhtar R, Soff GA. Activated-protein-C resistance in cancer patients. Haemostasis 1997; 27: 112-8.
Mielicki WP, Tenderenda M, Rutkowski P, ChojnowskiK. Activation of blood coagulation and the activity of cancer procoagulant (EC 188.8.131.52) in breast cancer patients. Cancel Lett 1999;46:61-6.
Malik Zeb Khan1, Muhammad Shoaib Khan1, Fazle Raziq1, Aziz Marjan Khattak2. Fibrinogen degradation products and D-Dimer in patients with breast carcinoma. Gomal J of Med Sci 2007; 5:9-12.
SPSS 14 .Statistical Package for Social Science. SPSS for windows Release14.0.0, 12. Standard Version, Copyright SPSS Inc., 1989-2006.
Wakai A, Gleeson A, Winter D. Role of fibrin D-dimer testing in emergency medicine. Emerg Med J 2003;20:319-25.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA: Cancer J Clin. 2015;65:5-29.
L Y Dirix,1 R Salgado,1,2 R Weytjens,1 C Colpaert,1,2 I Benoy,1 P Huget,, et al. Plasma fibrin D-Dimer levels correlate with tumor volume, progression rate and survival in patients with metastatic breast cancer. Br J Cancer 2002; 86:389-95.
Nagy Z. Biomarkers in solid tumors. Magy Onkol 2013; 57: 56-62.
Di Castelnuovo A1, de Curtis A, Costanzo S, Persichillo M, Olivieri M, Zito F,, et al. Association of D-dimer levels with all-cause mortality in a healthy adult population: findings from the MOLI-SANI study. Haematol 2013; 98: 1476-80.
Parkin DM, Bray F, Ferlay J et al Global cancer statistics, 2002. CA Cancer J Clin 2005; 55:74–108.
Blackwell K1, Haroon Z, Broadwater G, Berry D, Harris L, Iglehart JD, et al. Plasma D-dimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status. J Clin Oncol 2008; 18: 600-8.
Zhang PP, Sun JW, Wang XY,. Preoperative plasma D-dimer levels predict survival in patients with operable non-small cell lung cancer independently of venous thromboembolism. Eur J Surg Oncol 2013; 39: 951-56.
Di Micco P, Romano M, Niglio A, Nozzolillo P, Federico A, Petronella P, et al. Alteration of haemostasis in non-metastatic gastric cancer. Dig Liver Dis 2001;33:546-50.
Joensuu H1, Lehtimäki T, Holli K, Elomaa L, Turpeenniemi-Hujanen T, Kataja V, et al. Risk for distant recurrence of breast cancer detected by mammography screening or other methods. JAMA 2004; 292: 1064–73.
Isabelle Soerjomataram, Marieke WJ Louwman, Jacques G Ribot, Jan A Roukema, Jan Willem W Coebergh. An overview of prognostic factors for long-term survivors of breast cancer. Breast Cancer Res Treat 2008; 107(3): 309–30.