The combination of Ki67, histological grade and estrogen receptor status identifies a low-risk group among 1,854 chemo-naïve women with N0/N1 primary breast cancer

Abstract

BackgroundThe aim was to confirm a previously defined prognostic index, combining a proliferation marker, histological grade, and estrogen receptor (ER) in different subsets of primary N0/N1 chemo-naïve breast cancer patients.Methods/designIn the present study, including 1,854 patients, Ki67 was used in the index (KiGE), since it is the generally accepted proliferation marker in clinical routine. The low KiGE-group was defined as histological grade 1 patients and grade 2 patients which were ER-positive and had low Ki67 expression. All other patients made up the high KiGE-group. The KiGE-index separated patients into two groups with different prognosis. In multivariate analysis, KiGE was significantly associated with disease-free survival, when adjusted for age at diagnosis, tumor size and adjuvant endocrine treatment (hazard ratio: 3.5, 95% confidence interval: 2.6–4.7, P<0.0001).DiscussionWe have confirmed a prognostic index based on a proliferation marker (Ki67), histological grade, and ER for identification of a low-risk group of patients with N0/N1 primary breast cancer. For this low-risk group constituting 57% of the patients, with a five-year distant disease-free survival of 92%, adjuvant chemotherapy will have limited effect and may be avoided.

Ki67 Index in Breast Cancer: Correlation with Other Prognostic Markers and Potential in Pakistani Patients

“…This study also confirms the value of Ki67 evaluation as an objective means for prediction of prognosis as other recently published studies (Ferguson et al, 2013;Reyel et al, 2013;Strand et al, 2013).…”

Low concordance of biomarkers in histopathological and cytological material from breast cancer

“…The percentage of Ki67 ‐ positive cells is utilized to identify tumours with high proliferation . A high Ki67 index in ER‐positive tumours correlates with poor survival and a positive response to chemotherapy . In addition, PR status as well as Ki67 index can be used as part of the immunohistochemistry (IHC)‐based surrogate to discriminate luminal A from luminal B molecular subtypes.…”

“…15,[19][20][21] A high Ki67 index in ER-positive tumours correlates with poor survival and a positive response to chemotherapy. 8,21,22 In addition, PR status as well as Ki67 index can be used as part of the immunohistochemistry (IHC)-based surrogate to discriminate luminal A from luminal B molecular subtypes. PR-positive tumours with low Ki67 index are most probably of the luminal A type, whereas PR-negative tumours with a high Ki67 index are defined as luminal B.…”

The Association between Sentinel Lymph Node Metastasis and Ki-67 Labeling Index

“…On the other hand, Ki-67, a nucleus protein, is an immunohistochemical proliferation marker in many types of cancer and has been widely studied including breast cancer, and independently improved the prediction of treatment response and prognosis [26][27][28]. Ki-67 has been used to divide luminal A(ER/PR positive, HER negative and Ki-67 < 14%) and HER2 negative luminal B (ER/PR positive, HER negative and Ki-67  14%) in molecular subtype classification of St Gallen Consensus [29].…”