Role of D-dimer in patients of operable breast cancer with lymph node metastases: A matched cross-sectional study

Introduction: Breast cancer is the most common malignancy amongst women worldwide. Presence of axillary lymph nodes metastases is an important predictor of survival in patients with infiltrative breast cancer. D-dimer levels are elevated in the plasma of various solid tumor patients. There still exists a gap in our knowledge regarding the relationship between quantitative D-dimer levels and extent of disease in primary breast cancer. Aim: To study the fibrinolytic pathway by assaying D-dimer in breast cancer cases and to calculate a suggestive cutoff value for D-dimer for its use a specific marker of lymph node metastasis preoperatively in the cases of breast cancer. Materials and Methods: In this matched cross-sectional hospital-based study, 50 diagnosed cases of operable breast carcinoma not taking any treatment for the cancer and 50 healthy women both in the 25–65 years age group were selected as cases and controls, respectively. Peripheral venous blood was collected and analyzed for prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), D-dimer, platelet count, and mean platelet volume. Results: D-dimer was significantly increased in cases compared to healthy controls. It was markedly increased in patients with lymph node involvement irrespective with the number of nodes involved, while PT, aPTT, and TT did not show significant difference. Receiver operating characteristic curve gave a sensitivity of 56% and specificity of 91%, for cutoff value of 0.765 for D-dimer, in order to predict the chances of lymph node metastases preoperatively. Conclusions: D-dimer is a simple, noninvasive, quick, and nonexpensive laboratory investigation which can be used as a predictor of depicting lymph node metastasis.