Evaluation of Ki-67 Index in Core Needle Biopsies and Matched Breast Cancer Surgical Specimens

Ahn, Soomin; Lee, Junghye; Cho, Min Sun; Park, Sanghui; Sung, Sun Hee

doi:10.5858/arpa.2017-0014-oa

Cited by 24 publications

(34 citation statements)

References 22 publications

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“…Previous studies suggested that digital image analysis vs. visual determination might improve molecular subtype determination by immunohistochemistry [44]; however, comparative studies using digital image analysis in assessing Ki67-LI in CNB and SR are scarce. In these smaller cohorts, the reported agreement between CNB and SR was comparable with our results, although digital image analysis slightly improved determination [45,46]. Notably, none of these studies investigated the impact of molecular subtype/Ki67-LI determination on patient survival.…”

Section: Discussionsupporting

confidence: 87%

Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens

et al. 2020

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Reliable determination of Ki67 labeling index (Ki67-LI) on core needle biopsy (CNB) is essential for determining breast cancer molecular subtype for therapy planning. However, studies on agreement between molecular subtype and Ki67-LI between CNB and surgical resection (SR) specimens are conflicting. The present study analyzed the influence of clinicopathological and sampling-associated factors on agreement. Molecular subtype was determined visually by Ki67-LI in 484 pairs of CNB and SR specimens of invasive estrogen receptor (ER)–positive, human epidermal growth factor (HER2)–negative breast cancer. Luminal B disease was defined by Ki67-LI > 20% in SR. Correlation of molecular subtype agreement with age, menopausal status, CNB method, Breast Imaging Reporting and Data System imaging category, time between biopsies, type of surgery, and pathological tumor parameters was analyzed. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan–Meier method. CNB had a sensitivity of 77.95% and a specificity of 80.97% for identifying luminal B tumors in CNB, compared with the final molecular subtype determination after surgery. The correlation of Ki67-LI between CNB and SR was moderate (ROC-AUC 0.8333). Specificity and sensitivity for CNB to correctly define molecular subtype of tumors according to SR were significantly associated with tumor grade, immunohistochemical progesterone receptor (PR) and p53 expression (p < 0.05). Agreement of molecular subtype did not significantly impact RFS and OS (p = 0.22 for both). The identified factors likely mirror intratumoral heterogeneity that might compromise obtaining a representative CNB. Our results challenge the robustness of a single CNB-driven measurement of Ki67-LI to identify luminal B breast cancer of low (G1) or intermediate (G2) grade.

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Section: Discussionsupporting

confidence: 87%

Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens

et al. 2020

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“…There are reports about discrepancy between Ki-67 values assessed on core biopsies and surgical specimens, with some of them observing higher Ki-67 values on core biopsies [ 32 , 33 ] while others reported the opposite [ 34 ]. In the period of 2010–2014, in our institution Ki-67 was not routinely assessed on the initial biopsy, but was later done on the surgical specimen.…”

Section: Discussionmentioning

confidence: 99%

Do YOU know the Ki-67 index of your breast cancer patients? Knowledge of your institution’s Ki-67 index distribution and its robustness is essential for decision-making in early breast cancer

et al. 2020

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Objectives The proliferative activity of the Ki-67 index is important in decision-making of adjuvant treatments in early breast cancer. Its reliability can be reduced by inter-observer variability. This analysis’ objective is to evaluate the robustness of Ki-67 values within one center over 5 years and to compare its distribution with a published dataset. Materials and methods Ki-67 indices of early breast cancers treated at St. Gallen Breast Center were collected (2010–2014; 1154 patients). Distribution of Ki-67 values was analyzed for each year, along with histologic subtype and grading. Tumors were classified into intrinsic subtypes using two definitions: 2013 St. Gallen Consensus and the refined definition by Maisonneuve (“Milano Group”). Our institution’s Ki-67 cut-off value was adjusted to obtain the same distribution of luminal subtypes as published data of the Milano Group. Results Ki-67 index frequency distributions were comparable between years (mean 26–30%, median 22–26%). Shape and position of the distribution curves were nearly identical. Ki-67 values correlated with tumor grade (median Ki-67: G1: 12.0%, G2: 21%, G3: 38%). Standard deviation of Ki-67 increased with higher grading (G1: 6.9; G2: 9.2; G3: 18.2; p < 0.001). According to the 2013 definition (and refined definition respectively), there were 35% (41%) luminal A-like and 65% (59%) luminal B-like tumors. To obtain the same distribution as the Milano group, Ki-67 cut-off needed to be elevated to 22%. Conclusions Ki-67 index assessment was comparable over many years. Knowledge of one’s institution’s Ki-67 value distribution is essential for clinical decision-making of adjuvant therapies in early breast cancer.

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“…15 Ki-67 marker index (14% or more tumor cells with nuclear staining) is considered to be highly expressed. 16 …”

Section: Methodsmentioning

confidence: 99%

Associations of Estrogen Receptor, Progesterone Receptor, Human Epidemic Growth Factor Receptor-2 and Ki-67 with Ultrasound Signs and Prognosis of Breast Cancer Patients

Zhao¹,

Yang²,

Fu³

et al. 2021

CMAR

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Objective The functions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 in breast cancer have been explored. This study was carried out to explore ER, PR, HER-2 and Ki-67 expression levels in breast cancer patients and their relationship with ultrasound signs and prognosis. Patients and Methods A total of 274 female primary breast cancer patients received preoperative ultrasound examination. ER, PR, HER-2 and Ki-67 expression levels in breast cancer tissues were detected by immunohistochemical staining after surgery. The correlations of ER, PR, HER-2 and Ki-67 expression with ultrasound signs and prognosis of breast cancer patients were analyzed. Results The positive expression rate of ER, PR and HER-2 and Ki-67 high expression in 274 breast cancer patients was 73.36% (201/274), 59.85% (164/274), 24.09% (66/274) and 66.06% (181/274), respectively. ER-positive expression had association with lymph node metastasis (LNM) and blood flow grading; HER-2-positive expression was associated with LNM, while Ki-67-positive expression was related to the tumor diameter, LNM, and blood flow grading. LNM and Ki-67 high expression were risk factors for OS; PR-positive was a protective factor for OS; TNM stage, tumor diameter, LNM and Ki-67 high expression were risk factors for DFS in breast cancer patients. Conclusion ER, PR, HER-2 and Ki-67 in breast cancer are related to the ultrasound signs and prognosis of breast cancer patients. The joint detection of multiple indicators provides a reference for the individualized treatment of targeted drugs.

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Evaluation of Ki-67 Index in Core Needle Biopsies and Matched Breast Cancer Surgical Specimens

Abstract: - A significant difference in the Ki-67 index between core biopsy and surgical specimens was observed. Our findings indicate that it may be better to perform the Ki-67 assay on the core needle biopsy and the surgical specimen than on only one sample.

Cited by 24 publications

References 22 publications

Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens

Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens

Do YOU know the Ki-67 index of your breast cancer patients? Knowledge of your institution’s Ki-67 index distribution and its robustness is essential for decision-making in early breast cancer

Associations of Estrogen Receptor, Progesterone Receptor, Human Epidemic Growth Factor Receptor-2 and Ki-67 with Ultrasound Signs and Prognosis of Breast Cancer Patients

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