Tumour budding

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Tumour budding in colorectal carcinoma. H&E stain. (WC/Nephron)

Tumour budding refers to lone tumour cells or small clusters of tumour cells at the advancing front of a tumour.[1]



Definition in rectal carcinoma - based on international consensus:[4]

  • Tumour bud = 1-4 cell(s) -- at the tumour front.


  • Low grade: 0-4 tumour buds.
  • Intermediate grade: 5-9 tumour buds.
  • High grade: >=10 tumour buds.


  • Assessed in a field area of 0.785 mm2.[4]
    • Microscopes with a 22 mm eye pieces typically have a 0.2376 mm*mm field area with the 40x objective; thus, three fields is 0.7128 mm*mm.
    • Tumour budding was previously assessed in a field of 0.385 mm2.[1]
  • "Tumour buds suspended in pools of mucin should not be counted" as per the consensus.[4]



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There are <5 tumour buds/0.785 mm*mm; this tumour has low grade tumour budding.
There are 5-9 tumour buds/0.785 mm*mm; this tumour has intermediate grade tumour budding.
There are >=10 tumour buds/0.785 mm*mm; this tumour has high grade tumour budding.


The tumour is NEGATIVE for significant tumour budding (<5 buds/0.785 mm*mm).

See also


  1. 1.0 1.1 Ueno, H.; Murphy, J.; Jass, JR.; Mochizuki, H.; Talbot, IC. (Feb 2002). "Tumour 'budding' as an index to estimate the potential of aggressiveness in rectal cancer.". Histopathology 40 (2): 127-32. PMID 11952856.
  2. Mitrovic, B.; Schaeffer, DF.; Riddell, RH.; Kirsch, R. (Oct 2012). "Tumor budding in colorectal carcinoma: time to take notice.". Mod Pathol 25 (10): 1315-25. doi:10.1038/modpathol.2012.94. PMID 22790014.
  3. Gujam, FJ.; McMillan, DC.; Mohammed, ZM.; Edwards, J.; Going, JJ. (Sep 2015). "The relationship between tumour budding, the tumour microenvironment and survival in patients with invasive ductal breast cancer.". Br J Cancer 113 (7): 1066-74. doi:10.1038/bjc.2015.287. PMID 26263482.
  4. 4.0 4.1 4.2 Lugli, A.; Kirsch, R.; Ajioka, Y.; Bosman, F.; Cathomas, G.; Dawson, H.; El Zimaity, H.; Fléjou, JF. et al. (Sep 2017). "Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Consensus Conference (ITBCC) 2016.". Mod Pathol 30 (9): 1299-1311. doi:10.1038/modpathol.2017.46. PMID 28548122.