Immunohistochemical profiling of TNF-α in invasive ductal carcinoma of the breast - A cohort study from Rawalpindi, Pakistan

Breast cancer remains the most prevalent malignancy among women globally, and its incidence increasing, especially in developing countries. In Pakistan, breast cancer poses a significant public health challenge, with a notably high incidence rate among women. Tumor necrosis factor alpha (TNF-α) is a multifunctional cytokine that is commonly up-regulated in various tumors and is considered a tumor promoter element. Reports suggest the involvement of varying levels of TNF-α affecting Breast Cancer susceptibility. Given the diverse genetic, environmental, and lifestyle factors influencing cancer susceptibility, the expression and role of TNF- α in breast cancer may vary across regions. Therefore, it is crucial to explore its expression within specific to understand local disease biology and prognosis. We investigated the expression of TNF-α in 50 different female patients of invasive ductal carcinoma (IDC) of breast using immunohistochemical analysis. Fifty breast tumor biopsy samples and 17 lymph node biopsy specimens were collected. Our findings reveal an elevated expression of TNF-α in most cases analyzed within the local population. Elevated levels of TNF-α were particularly pronounced in metastatic tumors. Additionally, we observed a progressive increase in TNF-α expression in the endothelium as the tumor grade advanced (p-value= 0.044*). This study emphasizes the significant pro-tumor role of TNF in breast cancer within the local population, with elevated expression particularly evident in metastatic and higher-grade tumors.