The evaluation of demographic factors, clinicopathological characteristics and plasma D-dimer levels among breast cancer patients

Background: Breast cancer is the most common malignancy among women worldwide. Activation of coagulation and fibrinolysis is linked to tumor progression and metastasis. Plasma D-dimer, a fibrin degradation product, may serve as a biomarker of disease severity in breast cancer. The objectives of the study is to assess the association of plasma D-dimer levels with demographic and clinicopathological characteristics of breast cancer patients. Methods: This cross-sectional study was conducted in the Department of Pathology, Mymensingh Medical College, from September 2022 to October 2023. Eighty-six histopathologically confirmed breast cancer patients were enrolled. Data were collected using a structured questionnaire. Plasma D-dimer was measured and categorized as elevated or normal by laboratory reference values. Associations were analyzed using Chi-square and ANOVA tests; p<0.05 was considered significant. Results: Mean age was 49.57±9.96 years; invasive ductal carcinoma predominated (95.3%). Elevated D-dimer was found in 55 (64.0%) patients. Mean D-dimer rose significantly from 0.57±1.08 µg/ml in T1 to 3.47±1.33 µg/ml in T4 tumors (p<0.001), and from 0.57±1.09 µg/ml in N0 to 3.54±1.35 µg/ml in N3 disease (p<0.001). Elevated D-dimer was significantly associated with advanced tumor stage (p=0.00002) and lymph node metastasis (p<0.001), but not with lymphovascular invasion (p=0.158) or histological subtype (p=0.407). Conclusions: Plasma D-dimer was significantly associated with larger tumor size and greater nodal involvement, suggesting it may be a useful non-invasive biomarker of tumor progression. Larger prospective studies are needed to validate its prognostic value.