Prognostic Value of Ki-67 in Breast Cancer Patients with Positive Axillary Lymph Nodes: A Retrospective Cohort Study

Abstract

IntroductionKi-67 expression is a biomarker for proliferation. Its prognostic value is recognized in breast cancer (BC) patients with negative axillary nodes, but is less clear in BC patients with positive axillary lymph nodes.MethodsWe retrospectively reviewed the medical records of 1131 Chinese BC patients treated from January 2002 to June 2007 and 450 patients met the inclusion criteria: positive nodes, adjuvant therapy, and complete biomarker profile (estrogen receptor (ER), progesterone receptor (PR), HER2, p53, Ki-67). Univariate and multivariate regression analysis were used to correlate biomarkers and tumor characteristics with metastasis free survival (MFS) and overall survival (OS).ResultsMedian follow-up time was 46 months (range 5–76 months). The Ki-67 expression was associated significantly with histological grade, ER, PR, HER2, and P53 status (P<0.05). Tumor stage, nodal stage, and ER status were independent prognostic factors for MFS. Ki-67 status was associated significantly with OS but not MFS. To determine whether the extent of LN involvement in the BC patients influenced the role of Ki-67 in survival rates, we compared these variables in patients with 1–3 positive lymph nodes (N1) to those of patients with ≥4 positive lymph nodes. Ki-67 status was an independent prognostic factor for MFS (Hazard Ratio, 3.27, P = 0.026) and overall survival (HR, 10.64, P = 0.007) in patients with 1–3 positive nodes (N1).ConclusionsThe possibility that Ki-67 expression together with clinical factors can improve prediction of the prognosis of BC patients with 1∼3 positive axillary lymph nodes warrants further studies.

Patterns of distant metastasis in Chinese women according to breast cancer subtypes

“…HER2 positivity was defined as an immunohistochemical grade of 3+ (uniform and intensity membrane staining of > 30% of invasive tumor cells), or (after 2003 only) of 2+ determined by dual-probe fluorescence in situ hybridization. The cut-off point of higher Ki-67 expression was defined as 25% based on our previous studies [33]. Since Ki-67 data was missing for many patients, the BCS was not defined according to the St Gallen International Expert Consensus [34].…”

B7-H3 on circulating epithelial tumor cells correlates with the proliferation marker, Ki-67, and may be associated with the aggressiveness of tumors in breast cancer patients

“…Ki-67 (also known as MKI67) is a cellular marker that is tightly linked to the cell cycle. The fact that Ki-67 is universally expressed among proliferating cells and is absent in quiescent cells has led to the further evaluation of Ki-67 as a marker of proliferation (31). Although little is known about the exact function of the protein in dividing cells, Ki-67 is expressed during the G1, S and G2 phases of the cell cycle with a peak during mitosis and it is absent in the G0 phase (32,33).…”

Correlation Between &lt;i&gt;GATA-3&lt;/i&gt;, &lt;i&gt;Ki67&lt;/i&gt; and p53 Expressions to Histopathology Grading of Breast Cancer in Makassar, Indonesia

“…In 2011, Ki-67 was regarded as one of the factors influencing molecular subtypes. Ki-67 expression is closely associated with the growth and invasion of breast cancer: Ki-67 positive breast cancers are more active in growth, more aggressive in invasion, and more metastatic [3,7].…”

“…Ki-67 expression as detected by immunohistochemistry is one of the most variable indicators of the proliferative status of cancer cells and is referred to as Ki-67. In 2009 at the St-Gallen breast cancer conference, Ki-67 was recommended as a biomarker for prognosis and sensitivity of cancers to endocrine therapy or chemotherapy [3].…”