Journal article
Ki67 and breast cancer mortality in women with invasive breast cancer
- Abstract:
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Background: The percentage of cells staining positive for Ki67 is sometimes used for decision-making in patients with early invasive breast cancer (IBC). However, there is uncertainty regarding the most appropriate Ki67 cut points and the influence of interlaboratory measurement variability. We examined the relationship between breast cancer mortality and Ki67 both before and after accounting for interlaboratory variability and 8 patient and tumor characteristics.
Methods: A multicenter cohort study of women with early IBC diagnosed during 2009-2016 in more than 20 NHS hospitals in England and followed until December 31, 2020.
Results: Ki67 was strongly prognostic of breast cancer mortality in 8212 women with estrogen receptor (ER)–positive, human epidermal growth factor receptor 2 (HER2)–negative early IBC (Ptrend < .001). This relationship remained strong after adjustment for patient and tumor characteristics (Ptrend < .001). Standardization for interlaboratory variability did little to alter these results. For women with Ki67 scores of 0%-5%, 6%-10%, 11%-19%, and 20%-29% the corresponding 8-year adjusted cumulative breast cancer mortality risks were 3.3% (95% confidence interval [CI] = 2.8% to 4.0%), 3.7% (95% CI = 3.0% to 4.4%), 3.4% (95% CI = 2.8% to 4.1%), and 3.4% (95% CI = 2.8% to 4.1%), whereas for women with Ki67 scores of 30%-39% and 40%-100%, these risks were higher, at 5.1% (95% CI = 4.3% to 6.2%) and 7.7% (95% CI = 6.6% to 9.1) (Ptrend < .001). Similar results were obtained when the adjusted analysis was repeated with omission of pathological information about tumor size and nodal involvement, which would not be available preoperatively for patients being considered for neoadjuvant therapy.
Conclusion: Our findings confirm the prognostic value of Ki67 scores of 30% or more in women with ER-positive, HER2-negative early IBC, irrespective of interlaboratory variability. These results also suggest that Ki67 may be useful to aid decision-making in the neoadjuvant setting.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 823.2KB, Terms of use)
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- Publisher copy:
- 10.1093/jncics/pkad054
Authors
- Publisher:
- Oxford University Press
- Journal:
- JNCI Cancer Spectrum More from this journal
- Volume:
- 7
- Issue:
- 5
- Article number:
- pkad054
- Publication date:
- 2023-08-11
- Acceptance date:
- 2023-07-11
- DOI:
- EISSN:
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2515-5091
- Language:
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English
- Keywords:
- Pubs id:
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1545547
- Local pid:
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pubs:1545547
- Deposit date:
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2023-10-18
Terms of use
- Copyright holder:
- Probert et al.
- Copyright date:
- 2023
- Rights statement:
- © The Author(s) 2023. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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