Proliferative Markers in Breast Cancer and Chemotherapy Implications: A Comprehensive Review

Area of Science:

• Oncology
• Pathology
• Biomarkers

Background:

• Breast cancer is a leading global cause of cancer death in women.
• Predicting chemotherapy benefit remains a clinical challenge.
• Proliferative markers offer insights into tumor growth and treatment response.

Purpose of the Study:

• To review the clinical roles of Ki-67, mini chromosome maintenance (MCM) proteins, and proliferating cell nuclear antigen (PCNA) in breast cancer.
• To evaluate their implications for chemotherapy response.
• To explore emerging digital pathology techniques for marker quantification.

Main Methods:

• A narrative review of studies on Ki-67, MCM, PCNA, breast cancer, and chemotherapy was conducted.
• Searches were performed in PubMed, Scopus, and Google Scholar.
• Bibliometric analysis of publications from 2000-2023 was performed using R and VOSviewer.

Main Results:

• Ki-67 is a key predictor of neoadjuvant chemotherapy response.
• MCM proteins show promise across tumor grades; PCNA correlates with aggressive features.
• Post-chemotherapy Ki-67 changes impact survival; research is shifting to clinical applications and digital quantification.

Conclusions:

• Proliferative markers are essential in breast cancer management.
• Ki-67, MCM, and PCNA provide prognostic and predictive information.
• Integrating markers with digital pathology and AI can enhance personalized treatment.