Analytical cross-sectional study of correlation between plasma D-dimer levels and lymphovascular invasion in operable carcinoma breast.

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Background: Malignancy is frequently associated with a hypercoagulable state due to tumour-induced activation of coagulation and fibrinolysis. Plasma D-dimer, a fibrin degradation product, has emerged as a potential biomarker of tumour aggressiveness. Lymphovascular invasion (LVI) is a well-established histopathological predictor of metastasis and poor prognosis in breast cancer. This study aimed to evaluate the association between preoperative plasma D-dimer levels and LVI in operable carcinoma breast. Methods: This prospective analytical cross-sectional study was conducted in the Department of Surgical Oncology, Sri Devaraj Urs Medical College, Kolar, between June 2024 and December 2025. Seventy female patients aged ≥18 years with operable carcinoma breast were enrolled. Preoperative plasma D-dimer levels were measured prior to definitive surgery. Patients underwent either breast-conserving surgery or modified radical mastectomy. Histopathological examination assessed LVI status. Statistical analysis evaluated the correlation between D-dimer levels, LVI, tumour stage, and oral contraceptive use. Results: The majority of patients (63.2%) were between 41–60 years. LVI was present in 52.6% of cases. Mean plasma D-dimer levels were significantly higher in patients with LVI compared to those without LVI (825.85 ± 434.77 vs 227.77 ± 152.47; p < 0.001). D-dimer demonstrated excellent diagnostic performance for predicting LVI (sensitivity 98.0%, specificity 97.78%, PPV 98.0%, NPV 97.78%, overall accuracy 97.89%). No significant association was observed between D-dimer levels and oral contraceptive use (p = 0.219). Although LVI prevalence increased with advancing stage, statistical significance was not reached (p = 0.109). Conclusions: Preoperative plasma D-dimer levels show a strong association with lymphovascular invasion in operable breast cancer. D-dimer is a simple, cost-effective, and non-invasive biomarker that may help identify aggressive tumour biology preoperatively. Larger multicentric studies are warranted to validate its role in prognostic stratification and clinical decision-making.