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. 2011 Mar 2;13(2):R22.
doi: 10.1186/bcr2834.

Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis

Bhumsuk Keam  1 , Seock-Ah Im, Kyung-Hun Lee, Sae-Won Han, Do-Youn Oh, Jee Hyun Kim, Se-Hoon Lee, Wonshik Han, Dong-Wan Kim, Tae-You Kim, In Ae Park, Dong-Young Noh, Dae Seog Heo, Yung-Jue Bang
Affiliations

Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis

Bhumsuk Keam et al. Breast Cancer Res. .

Abstract

Introduction: Triple negative breast cancer (TNBC) has a poorer survival, despite a higher response rate to neoadjuvant chemotherapy. The purpose of this study was to identify the predictive or prognostic value of Ki-67 among patients with TNBC treated with neoadjuvant chemotherapy, and the role of Ki-67 in further classification of TNBC.

Methods: A total of 105 TNBC patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were included in the present study. Pathologic complete response (pCR) rate, relapse-free survival (RFS), and overall survival (OS) were compared according to the level of Ki-67.

Results: pCR was observed in 13.3% of patients. TNBC with high Ki-67 expression (≥ 10%) showed a higher pCR rate to neoadjuvant chemotherapy than TNBC with low Ki-67 expression. None of the low Ki-67 group achieved pCR (18.2% in the high Ki-67 group vs. 0.0% in the low Ki-67 group, P = 0.019). However, a high Ki-67 expression was significantly associated with poor RFS and OS in TNBC, despite a higher pCR rate (P = 0.005, P = 0.019, respectively). In multivariate analysis, high Ki-67 was an independent prognostic factor for RFS in TNBC (hazard ratio = 7.82, P = 0.002). The high Ki-67 group showed a similar pattern of recurrence with overall TNBC, whereas the low Ki-67 group demonstrated a relatively constant hazard rate for relapse.

Conclusions: TNBC with high Ki-67 was associated with a more aggressive clinical feature despite a higher pCR rate. High proliferation index Ki-67 can be used for further classification of TNBC into two subtypes with different responses and prognosis.

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Figures

Figure 1
Figure 1
Kaplan-Meier curve of (A) relapse-free survival and (B) overall survival by Ki-67 in triple negative breast cancer.
Figure 2
Figure 2
Relapse-free survival (RFS) as a function of pathologic response. Residual disease (RD) with high Ki-67 showed poorer RFS than RD with low Ki-67 and pathologic complete response (pCR) with high Ki-67.
Figure 3
Figure 3
Smoothed relapse hazard as shown by hazard function in TNBC. (A) Hazard functions for relapse in all TNBC patients. (B) Hazard functions for relapse by Ki-67.
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