Document Detail

Prognostic value of estrogen receptor and Ki-67 index after neoadjuvant chemotherapy in locally advanced breast cancer expressing high levels of proliferation at diagnosis.
MedLine Citation:
PMID:  21372600     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Breast cancers expressing high levels of Ki-67, a nuclear marker of cell proliferation, are associated with worse outcome. Recent data from neoadjuvant studies indicate that a single measurement of the nuclear proliferation marker Ki-67 in breast carcinoma during neoadjuvant therapy is strongly predictive of long-term outcome. Secondly, recent literature data indicate that prognostic evaluation with Ki-67 may be better after pre-surgical therapy. A retrospective study from a prospectively maintained clinical database to compare the predictive and prognostic significance of biological markers, assessed before and after neoadjuvant chemotherapy, in locally advanced breast cancer, was performed.
PATIENTS AND METHODS: The following parameters were considered before and after chemotherapy for their relationship with treatment response and disease-free survival in 64 patients with locally advanced breast cancer: clinical stage, clinical and pathological lymph node involvement, Ki-67, estrogen receptor (ER), progesterone receptor (Pgr), Her2, tumor grade, clinical response, type of surgery performed, and number of chemotherapy cycles administered. The expression of Ki-67 was assessed using immunohistochemistry in pre-therapy tru-cut and post-therapy surgical excision specimens after neoadjuvant chemotherapy; only patients with breast tumors expressing high baseline Ki-67 (≥ 15%) were included in the analysis. In addition, the correlation between pre-chemotherapy biological markers and clinical and pathological response was reported.
RESULTS: Post-chemotherapy Ki-67 proliferation index decrease, pre-chemotherapy ER expression and post-chemotherapy ER expression were the only significant prognostic factors adversely influencing disease-free survival in univariate analysis. Her2 overexpression was the only factor to impact on the clinical response.
CONCLUSIONS: Post-treatment Ki-67 and ER status were predictors of outcome for patients with locally advanced breast cancer and a high pre-chemotherapy proliferation index.
L Miglietta; P Vanella; L Canobbio; C Naso; N Cerisola; P Meszaros; M A Parodi; F Morabito
Publication Detail:
Type:  Journal Article     Date:  2011-03-04
Journal Detail:
Title:  Oncology     Volume:  79     ISSN:  1423-0232     ISO Abbreviation:  Oncology     Publication Date:  2010  
Date Detail:
Created Date:  2011-03-30     Completed Date:  2011-05-31     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  0135054     Medline TA:  Oncology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  255-61     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
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MeSH Terms
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Breast Neoplasms / drug therapy*,  metabolism*
Carcinoma, Ductal, Breast / drug therapy,  metabolism
Carcinoma, Lobular / drug therapy,  metabolism
Cell Proliferation
Immunoenzyme Techniques
Middle Aged
Neoadjuvant Therapy*
Prospective Studies
Receptor, erbB-2 / metabolism
Receptors, Estrogen / metabolism*
Receptors, Progesterone / metabolism
Retrospective Studies
Survival Rate
Young Adult
Reg. No./Substance:
0/Receptors, Estrogen; 0/Receptors, Progesterone; EC, erbB-2

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