Charusheila Ramkumar, Chandra Prakash, Lekshmi Madhav, Arun Kumar, Chetana Basavaraj, Prathima R, Nirupama Naidu, and Manjiri M Bakre
The prognostic utility of the proliferation marker Ki67 to decide breast cancer treatment has been widely investigated and continues to be a source of much controversy. In this study, we evaluated: i) the role of Ki67 as a prognostic and predictive tool in patients with hormone receptor positive (ER+/PR+) carcinoma of the breast and ii) analyzed its correlation with two commonly used clinicopathological parameters, viz node status and tumor grade to predict clinical outcomes. To determine the clinical utility of Ki67 in assessment of breast cancer prognosis, we examined its expression by immunohistochemistry (IHC) in a series of 160 hormone receptor positive patients in a retrospective cohort of Indian patients. Patients were stratified based on Ki67 expression and analyzed for 5-year distant metastasis free survival (DMFS). Amongst the baseline clinicopathologic variables, we found node status, tumor grade, and age correlated significantly with outcome. However no significant correlation was found between Ki67 based risk stratification and patient outcome. Interestingly, increased Ki67 expression was found to correlate significantly with higher tumor grade but not with worse DMFS. In our study, conducted in an Indian cohort comprising 160 patients, Ki67 was not found to be significantly prognostic or predictive in patients with hormone receptor positive breast cancer.
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