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Roles of Ki67 in Breast Cancer - Important for Management?

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The Ki-67 index, a breast cancer proliferation marker, showed associations with tumor characteristics in Asian women. However, it would have minimally impacted treatment decisions for early-stage breast cancer patients.

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Area of Science:

  • Oncology
  • Pathology

Background:

  • Standard breast cancer biomarkers include estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).
  • The Ki-67 index, a measure of cell proliferation, is increasingly used in treatment decisions despite lacking standardized assessment.
  • Its role in Asian women with breast cancer requires further investigation.

Purpose of the Study:

  • To investigate the clinical significance of the Ki-67 index in a cohort of Asian women diagnosed with invasive breast cancer.
  • To determine the association between Ki-67 status and various clinicopathological factors.

Main Methods:

  • A total of 450 women with Stage 1-3 invasive breast cancer were analyzed.
  • Univariable and multivariable logistic regression models were employed to assess the relationship between Ki-67 (≥14%) and factors like age, ethnicity, grade, ER, PR, HER2, lymph node status, and tumor size.
  • Statistical analyses were conducted using SPSS Version 22.

Main Results:

  • Univariable analysis revealed associations between Ki-67 and younger age, higher tumor grade, ER/PR negativity, HER2 positivity, high mitotic index, and positive lymph nodes.
  • Multivariable analysis identified tumor size, grade, PR, and HER2 as significant independent predictors of Ki-67 status.
  • In stage 1 patients with ER+/PR+/HER2- and non-grade 3 tumors, only 4.9% had positive Ki-67, with none receiving chemotherapy.

Conclusions:

  • The Ki-67 index's information would have minimally altered treatment management for a small fraction of stage 1 breast cancer patients.
  • Further standardization of Ki-67 assessment is crucial for its reliable application in clinical practice.