Objective: Ki-67 plays an important function in cell division, but its exact role is still unknown. Moreover, few works regarding its overall function were published. The present study evaluated the clinical significance of Ki-67 index as a prognostic marker and predictor of recurrence in different molecular subtypes of breast cancer. The relationship of Ki-67 index with different clinicopathological factors was also analyzed. Methods: Ki-67 index was measured in 107 cases of primary breast cancer from 2010-2012. These patients were evaluated for estrogen receptor, progesterone receptor, and HER2. Ki-67 was divided according to percentage levels: < 15% and > 15%. Followup ranged from 32 months up to 6 years.Results: Approximately 44, 23, 15, and 25 cases were grouped as luminal A, luminal B, HER2 subtype, and triple-negative (TN), respectively. No luminal A patients showed Ki-67 level higher than 15%, and their recurrence was 20%. In luminal B group, Ki-67 level higher than 15% was observed in 69% of patients, and recurrence was 39%. In HER2 subtype, Ki-67 was higher than 15% in 34% of cases, and recurrence was 40%. In triple-negative cases, Ki-67 was higher than 15% in 60% of cases, and recurrence was detected in 32% of patients. Patients with Ki-67 less than 15% displayed better overall survival than those with Ki-67 higher than 15% (P = 0.01). Patients with Ki-67 higher than 15% exhibited higher incidence of metastasis and recurrence than those with Ki-67 less than 15% (P = 0.000).Conclusions: Ki-67 may be considered as a valuable biomarker in breast cancer patients.

Background and aim: Breast cancer is the commonest malignant tumor and a common cause of cancer death in women all over the world. Some recent studies attributed breast cancer to viral infection. This study aimed to evaluate the expression of HCMV, EBV and HPV in invasive carcinoma of the breast among the Egyptian women by immunohistochemistry and whether there is a relationship between the prognostic factors of breast carcinoma and these viruses. Patients and methods: This retrospective study included 107 selected cases of invasive breast carcinoma. Slides cut from tissue microarray prepared blocks were stained immunohistochemically for HCMV, EBV and HPV antigens. The association of such viruses with the clinicopathological features, tumor recurrence and patient death was evaluated statistically. Result: HCMV, EBV and HPV were present in 43.9%, 10.3% and 24.3% of cases respectively. HCMV was associated significantly with the tumor grade, mitotic count (P = .01), IDC, ER, PR, Her2/neu and molecular subtype (P = .032, .002, .02, .005, .003) respectively. EBV was associated with the tumor size, stage and histological type (P = . 025, .005, .009) respectively. HPV wasn't associated with any of the clinicopathological characteristics. None of these viruses was associated with the tumor recurrence or patient death. Conclusion: HCMV and EBV might be contributing factors for the development and behavioural alteration of breast carcinoma, representing potential tools for the detection of specific therapies for this cancer. Further studies on a larger number of cases using other techniques such as CISH for specific typing of the viruses especially HPV can add more information.

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