A prognostic model based on combining estrogen receptor expression and Ki-67 value after neoadjuvant chemotherapy predicts clinical outcome in locally advanced breast cancer: Extension and analysis of a previously reported cohort of patients

L. Miglietta, F. Morabito, N. Provinciali, L. Canobbio, P. Meszaros, C. Naso, R. Murialdo, M. Boitano, S. Salvi, M. Ferrarini

Research output: Contribution to journalArticlepeer-review

Abstract

Background Ki-67 expression has gained attention as a breast cancer prognostic factor, however its significance in the remaining malignant cells after neoadjuvant chemotherapy (NAC) has been rarely examined. This investigation, extension and analysis of a previously reported cohort of patients, evaluates the significance of Ki-67 and estrogen receptor (ER) expression after NAC in LABC (locally advanced breast cancer). Patients and methods clinical stage, tumor size, clinical and pathological lymph node involvement, Ki-67, ER, progesterone receptor (PgR), HER2 expression, grading and clinical response were evaluated before and after NAC in 110 patients with LABC. Ki-67 expression was assessed both in pre and post-therapy histological samples, using >15% positive cells as cut-off value to distinguish high from low Ki-67 expressing tumors. Results six patients (5.45%) attained pCR after NAC. A significant relationship between elevated post-CT Ki-67 and ER expression was showed at Cox multivariate analysis of disease free survival (DFS). On univariate analysis high post-chemotherapy Ki-67 and ER status were associated with worse survival; at multivariate model included these results were confirmed. Based on these two parameters, a prognostic model identified two different groups: low risk (low postchemotherapy Ki-67 and ER positive, or either high post-chemotherapy Ki-67 or ER negative), and high risk (high post-chemotherapy Ki-67 and ER negative). The low risk group showed a good prognosis (median OS still not reached), while the high risk group had a worse OS (median 41 months). Conclusions Ki-67 value after NAC and ER status could predict a worse prognosis among LABC patients treated with NAC.

Original languageEnglish
Pages (from-to)1046-1052
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume39
Issue number10
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Estrogen receptor
  • Immunohistochemical score
  • Ki-67
  • Locally advanced breast cancer
  • Neoadjuvant chemotherapy
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Surgery

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