Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis
Background: Breast cancer is a heterogenous group of diseases classified into the biological subtypes luminal A, luminal B, HER2-enriched and triple negative. These subtypes have different treatment response patterns and survival rates. Ki-67 is the most commonly used proliferative marker in breast...
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doaj-80861039c848446f82fa738ba1657df02020-11-25T04:03:20ZengKasr Al-Ainy Center of Clinical Oncology and Nuclear MedicineResearch in Oncology2357-06872357-06952020-12-01162354110.21608/resoncol.2019.11423.1075Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective AnalysisWael Makar0Shaimaa Lasheen1Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, EgyptClinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, EgyptBackground: Breast cancer is a heterogenous group of diseases classified into the biological subtypes luminal A, luminal B, HER2-enriched and triple negative. These subtypes have different treatment response patterns and survival rates. Ki-67 is the most commonly used proliferative marker in breast cancer and is used for the distinction between luminal A and B subtypes. Methods: A retrospective study that included patients with early breast cancer diagnosed between 2010 and 2016 and treated in a single cancer center. Results: The medical records of 498 patients were retrospectively reviewed. The median age of patients was 51 years (range: 21 – 81) and the median value of Ki-67 level among them was 20% (interquartile range: 10-30%). Ki-67 was significantly higher in younger (<35 years) and premenopausal patients (p=0.0002 and 0.0055, respectively). Higher Ki-67 level associated significantly with higher T stage, estrogen and progesterone receptors-negativity, HER2-positivity and higher grade (p=0.0256, <0.0001, <0.0001, =0.0001 and =0.0031; respectively). Univariate Cox regression analysis showed that the ≥14% and ≥20% cutoff values of Ki-67 level are associated with poorer disease-free survival (DFS) (HR=1.989 [95%CI: 1.163-3.402, p=0.0121] and HR=1.616 [95%CI: 1.001-2.61, p=0.0496], respectively). On stratifying patients according to the Ki-67 proliferation index into three strata, <14%, ≥14%--<20% and ≥20%; DFS differed significantly between them (p=0.0394). The 5-year DFS rate for the three strata was 82.2%, 64.7% and 64.8%; respectively. Conclusion: Early breast cancer patients with lower Ki-67 levels have significantly better DFS. A Ki-67 cutoff value of ≥14% appears to correlate better with DFS than the newer cutoff value of ≥20%. https://resoncol.journals.ekb.eg/article_105973_a6a27eb70bcfe4f4a60f607bafcc215d.pdfbiological subtypescutoff valueearly breast cancerki-67 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wael Makar Shaimaa Lasheen |
spellingShingle |
Wael Makar Shaimaa Lasheen Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis Research in Oncology biological subtypes cutoff value early breast cancer ki-67 |
author_facet |
Wael Makar Shaimaa Lasheen |
author_sort |
Wael Makar |
title |
Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis |
title_short |
Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis |
title_full |
Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis |
title_fullStr |
Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis |
title_full_unstemmed |
Assessment of the Prognostic Role of Ki-67 and Its Optimal Cutoff Value in Early Breast Cancer: A Retrospective Analysis |
title_sort |
assessment of the prognostic role of ki-67 and its optimal cutoff value in early breast cancer: a retrospective analysis |
publisher |
Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine |
series |
Research in Oncology |
issn |
2357-0687 2357-0695 |
publishDate |
2020-12-01 |
description |
Background: Breast cancer is a heterogenous group of diseases classified into the biological subtypes luminal A, luminal B, HER2-enriched and triple negative. These subtypes have different treatment response patterns and survival rates. Ki-67 is the most commonly used proliferative marker in breast cancer and is used for the distinction between luminal A and B subtypes.
Methods: A retrospective study that included patients with early breast cancer diagnosed between 2010 and 2016 and treated in a single cancer center.
Results: The medical records of 498 patients were retrospectively reviewed. The median age of patients was 51 years (range: 21 – 81) and the median value of Ki-67 level among them was 20% (interquartile range: 10-30%). Ki-67 was significantly higher in younger (<35 years) and premenopausal patients (p=0.0002 and 0.0055, respectively). Higher Ki-67 level associated significantly with higher T stage, estrogen and progesterone receptors-negativity, HER2-positivity and higher grade (p=0.0256, <0.0001, <0.0001, =0.0001 and =0.0031; respectively). Univariate Cox regression analysis showed that the ≥14% and ≥20% cutoff values of Ki-67 level are associated with poorer disease-free survival (DFS) (HR=1.989 [95%CI: 1.163-3.402, p=0.0121] and HR=1.616 [95%CI: 1.001-2.61, p=0.0496], respectively). On stratifying patients according to the Ki-67 proliferation index into three strata, <14%, ≥14%--<20% and ≥20%; DFS differed significantly between them (p=0.0394). The 5-year DFS rate for the three strata was 82.2%, 64.7% and 64.8%; respectively.
Conclusion: Early breast cancer patients with lower Ki-67 levels have significantly better DFS. A Ki-67 cutoff value of ≥14% appears to correlate better with DFS than the newer cutoff value of ≥20%.
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topic |
biological subtypes cutoff value early breast cancer ki-67 |
url |
https://resoncol.journals.ekb.eg/article_105973_a6a27eb70bcfe4f4a60f607bafcc215d.pdf |
work_keys_str_mv |
AT waelmakar assessmentoftheprognosticroleofki67anditsoptimalcutoffvalueinearlybreastcanceraretrospectiveanalysis AT shaimaalasheen assessmentoftheprognosticroleofki67anditsoptimalcutoffvalueinearlybreastcanceraretrospectiveanalysis |
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