Tumor budding is a discohesive change seen along the advancing edge of an adenocarcinoma.
A tumor bud is defined as an isolated malignant cell or small cluster of 2-4 cells along the invasive front.
Ueno et al quantified tumor budding by counting the number of foci seen within the microscopic field using a x20 objective (field area 0.785 square mm):
(1) Grade 0: none
(2) Grade 1: 1-4 foci
(3) Grade 2: 5-9 foci
(4) Grade 3: >= 10 foci
The field chosen should be in a "hotspot".
These grades are referred to as Bd1 to Bd3 (with Bd for "budding").
Tumor budding is an independent predictor of lymph node metastases in pT1 and other colorectal carcinomas.
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