Prognostic value of Ki67 in phyllodes tumor of the breast: A systematic review and meta‑analysis

Fahd Refai ¹

⁰Department of Pathology, Faculty of Medicine, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah 25668, Saudi Arabia.

Experimental and Therapeutic Medicine +

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October 31, 2024

View abstract on PubMed

Summary

A high Ki67 index in breast phyllodes tumors (PT) is linked to an increased risk of adverse outcomes and recurrence. This finding suggests Ki67 may help identify patients needing closer monitoring, even with benign disease.

Area Of Science

Oncology
Pathology
Biomarkers

Background

Phyllodes tumors (PT) of the breast carry a risk of recurrence, even benign cases.
Current predictive markers for PT outcomes are insufficient for guiding management.
The prognostic value of the Ki67 index in PT remains uncertain.

Purpose Of The Study

To systematically review and meta-analyze the association between Ki67 expression and adverse clinical outcomes in breast PT.
To determine if Ki67 can serve as a predictive marker for recurrence in PT patients.

Main Methods

Systematic search of PubMed/MEDLINE, Web of Science, Scopus, Embase, and Cochrane Library databases.
Extraction of study characteristics and outcomes (recurrence, survival) based on Ki67 status.
Pooled log odds ratios (OR) with 95% CI using a random-effects model for five eligible studies (280 cases).

Main Results

A high Ki67 index (Ki67 >10% or >11.2%) was associated with a significantly increased odds of adverse outcomes (log OR, 1.26; P=0.005).
Adverse outcome rates were 28.7% for Ki67-high vs. 9.4% for Ki67-low populations.
All included studies were of good quality (Newcastle-Ottawa Scale score of 8), with no significant publication bias.

Conclusions

A Ki67 index >10% is associated with an increased risk of recurrence in breast phyllodes tumors.
Re-evaluation of Ki67's prognostic value in larger cohorts is warranted to identify patients at risk.
Establishing Ki67's role could refine follow-up strategies for PT patients, especially those with benign histology.

Keywords:

Ki67 phyllodes tumor prognosis proliferation recurrence