Risk Factors Associated with Discordant Ki-67 Levels between Preoperative Biopsy and Postoperative Surgical Specimens in Breast Cancers

Kim, Hyung Sun; Park, Seho; Koo, Ja Seung; Kim, Sanghwa; Kim, Jee Ye; Nam, Seok Woo; Park, Hyung Seok; Kim, Kyung Sik; Park, Byeong Woo

doi:10.1371/journal.pone.0151054

Cited by 16 publications

(19 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have reported only fair to moderate agreement for Ki67 testing between core samples and surgical excisions. 16 , 17 , 19 Recent studies by Chen et al 16 and Kim et al 17 showed an increase in Ki67 value in SRS and identified the associated risk factors. These results are concordant with our study showing that Ki67 value was higher at surgery than at biopsy (24.4% vs 19.1%, P <0.01), while ER, PR and HER2 statuses were consistent in both samples.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of core needle biopsy and subsequent neoadjuvant chemotherapy on molecular alterations and outcome in breast cancer

Xie

Wang

et al. 2018

OTT

View full text Add to dashboard Cite

ObjectivesThe aim of our study is to evaluate the effect of core needle biopsy (CNB) and subsequent neoadjuvant chemotherapy (NAC) on the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth hormone receptor 2 (HER2) and Ki67 in breast cancer, and the associated influencing factors.Materials and methodsIn this retrospective cohort study, 143 patients with primary operable breast cancer who received NAC were included. ER, PR, HER2 and Ki67 statuses were compared between pretreatment and posttreatment residual samples. A control group of paired core and excision tumors from 123 patients who did not receive NAC within the same study period was also assessed. Data on patients’ clinicopathologic features were collected to identify associated influencing factors.ResultsKi67 value significantly increased in excision tumors compared with paired core samples in controls without presurgery treatment (P<0.01), which was associated with the pathologic lymph node status and the interaction of PR and HER2 status (P=0.008 and 0.028, respectively). In 143 patients who underwent NAC, a significant decrease was observed in the expression of PR and Ki67 after NAC (P=0.003 and P<0.01, respectively). Further subgroup analysis showed that PR decrease was more obvious in premenopausal patients and Luminal A patients (P=0.006 and 0.002, respectively).ConclusionCore samples could provide more reliable information on determination of molecular subtype than surgical excisions. Decreases in PR and Ki67 expression following NAC could be used as positive prognostic factors. We recommend repeat testing of these biologic markers following NAC for the sake of better disease management. To the best of our knowledge, this is the most comprehensive study to analyze the effect of neoadjuvant chemotherapy on molecular alteration and its associated influencing factors after reporting a CNB-associated Ki67 increase in the same study.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 16 This result is supported by Kim et al, who further demonstrated that a substantial discordance in Ki67 after biopsy was significantly associated with variables including tumor size >1 cm, negative PR expression, grade III cancer and age 35 years. 17 …”

Section: Introductionmentioning

confidence: 99%

Effects of core needle biopsy and subsequent neoadjuvant chemotherapy on molecular alterations and outcome in breast cancer

Xie

Wang

et al. 2018

OTT

View full text Add to dashboard Cite

show abstract

“…Previous studies investigating concordance between core needle biopsy and surgical specimens showed various results. 9,10,[14][15][16][17][18] Although some studies showed a higher Ki-67 index in core biopsy specimens, 14,15 other studies showed a higher Ki-67 index in surgical specimens. 9,10 Most studies reported a moderate rate of concordance between the 2 tissue types.…”

Section: Discussionmentioning

confidence: 99%

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

Ahn

Lee

Cho³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…Many studies have verified correlations between the degree of Ki67 reduction and pathological response to NAC [ 10 , 35 , 36 ], yet controversies exist regarding the relationships between Ki67 index, pathological response, and survival grates. Some studies only find significant Ki67 proliferation index differences when comparing pre-NAC with post-surgery in Luminal subtypes [ 37 , 38 ] while other studies have demonstrated that Ki67 reduction also plays a role in TN breast cancer [ 39 , 40 ]. While a separate investigation mentioned

, it only discussed its prognostic role and predictive value within 90 Luminal subtype patients with neoadjuvant letrozole-based treatment without classifying it more broadly [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Quantification of Ki67 Change as a Valid Prognostic Indicator of Luminal B Type Breast Cancer After Neoadjuvant Therapy

Tan¹,

Fu²,

Xu³

et al. 2021

Pathol. Oncol. Res.

View full text Add to dashboard Cite

Introduction: Ki67 value and its variation before and after neoadjuvant chemotherapy are commonly tested in relation to breast cancer patient prognosis. This study aims to quantify the extent of changes in Ki67 proliferation pre- and post-neoadjuvant chemotherapy, confirm an optimal cut-off point, and evaluate its potential value for predicting survival outcomes in patients with different molecular subtypes of breast cancer.Methods: This retrospective real-world study recruited 828 patients at the Department of Breast Surgery of the First Affiliated Hospital of China Medical University and the Cancer Hospital of China Medical University from Jan 2014 to Nov 2020. Patient demographic features and disease pathology characteristics were recorded, and biomarkers were verified through immunohistochemistry. Various statistical methods were used to validate the relationships between different characteristics and survival outcomes irrespective of disease-free and overall survival.Results: Among 828 patients, statistically significant effects between pathological complete response and survival outcome were found in both HER2-enriched and triple-negative breast cancer (p < 0.05) but not in Luminal breast cancer (p > 0.05). Evident decrease of Ki67 was confirmed after neoadjuvant chemotherapy. To quantify the extent of Ki67 changes between pre- and post-NAC timepoints, we adopted a computational equation termed ΔKi67% for research. We found the optimal cut-off value to be “ΔKi67% = −63%” via the operating characteristic curve, defining ΔKi67% ≤ −63% as positive status and ΔKi67% > −63% as negative status. Patients with positive ΔKi67% status were 37.1% of the entire cohort. Additionally, 4.7, 39.9, 34.5 and 39.6% of patients with Luminal A, Luminal B, HER2-enriched and triple negative breast cancer were also validated with positive ΔKi67% status. The statistically significant differences between ΔKi67% status and prognostic outcomes were confirmed by univariate and multivariate analysis in Luminal B (univariate and multivariate analysis: p < 0.05) and triple negative breast cancer (univariate and multivariate analysis: p < 0.05). We proved ΔKi67% as a statistically significant independent prognostic factor irrespective of disease-free or overall survival among patients with Luminal B and triple-negative breast cancer.Conclusions:ΔKi67% can aid in predicting patient prognostic outcome, provide a measurement of NAC efficacy, and assist in further clinical decisions, especially for patients with Luminal B breast cancer.

show abstract

Risk Factors Associated with Discordant Ki-67 Levels between Preoperative Biopsy and Postoperative Surgical Specimens in Breast Cancers

Cited by 16 publications

References 23 publications

Effects of core needle biopsy and subsequent neoadjuvant chemotherapy on molecular alterations and outcome in breast cancer

Effects of core needle biopsy and subsequent neoadjuvant chemotherapy on molecular alterations and outcome in breast cancer

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

Quantification of Ki67 Change as a Valid Prognostic Indicator of Luminal B Type Breast Cancer After Neoadjuvant Therapy

Contact Info

Product

Resources

About