Журнал клинических случаев

Evaluation of Plasma D-Dimer Level as a Predictve Marker of Advanced Carcinoma Breast

Abstract

Bhavesh Devkaran, Kapil Dev Negi, Sudershan Sharma and Jaswal S

Purpose: Evaluation of plasma d-dimer level as a predictive marker of advanced carcinoma breast.
Backround: The relationship between malignancy and thrombosis is known for over 100 years. Thrombocytosis,
an increase in fibrinogen and fibrin degradation products like D-dimer, a rise in factors V,VII,VIII , IX, and XI levels,
and a decrease in antithrombin III , are seen in cancer patients. Extracellular remodeling of fibrin is essential for
angiogenesis in tumors, and activation of intravascular fibrin formation and degradation has been shown to occur in
the plasma of breast cancer patients.
Material and methods: This study was conducted in the Department of Surgery in I.G.M.C. Shimla & included
90 patients admitted in surgery ward/ presenting in the O.P.D. Patients were randomized into three equal groups
of 30 patients each. Group 1 included patients of Diagnosed breast Carcinoma and Group 2 included patients of
Diagnosed Benign breast diseases and Group 3 included Healthy females. Plasma D- Dimer value of all groups
were compared. Modified radical mastectomy was performed of Group 1 patients. HPE of breast specimen done and
pathological examination report were analysed with Plasma D- Dimer value.
Results: Plasma D-Dimer value was normal i.e. <0.25 mg/l in all Group 2 & Group 3 patients, while in Group 1
it was increased in 90% of the patients.
There was stasticaly significant correlation between Mean values of plasma D- Dimer and advancing stage of
disease, tumour size histological grade and lymphovascular invasion.
Conclusion: Plasma D-Dimer level is elevated in breast carcinoma, especially in those with advanced stage.
Increased D-Dimer level is a important marker of clinical stage, lymhovascular invasion, lymph node involvement
& tumor metastasis. So Preoperative Plasma D-Dimer may prove to be a safe, convenient and easily available
predictive marker of advanced breast carcinoma.