Ki67 and breast cancer mortality in women with invasive breast cancer.
Journal
JNCI cancer spectrum
ISSN: 2515-5091
Titre abrégé: JNCI Cancer Spectr
Pays: England
ID NLM: 101721827
Informations de publication
Date de publication:
31 08 2023
31 08 2023
Historique:
received:
30
04
2023
revised:
24
07
2023
accepted:
31
07
2023
medline:
15
9
2023
pubmed:
12
8
2023
entrez:
11
8
2023
Statut:
ppublish
Résumé
The percentage of cells staining positive for Ki67 is sometimes used for decision-making in patients with early invasive breast cancer (IBC). However, there is uncertainty regarding the most appropriate Ki67 cut points and the influence of interlaboratory measurement variability. We examined the relationship between breast cancer mortality and Ki67 both before and after accounting for interlaboratory variability and 8 patient and tumor characteristics. A multicenter cohort study of women with early IBC diagnosed during 2009-2016 in more than 20 NHS hospitals in England and followed until December 31, 2020. Ki67 was strongly prognostic of breast cancer mortality in 8212 women with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative early IBC (Ptrend < .001). This relationship remained strong after adjustment for patient and tumor characteristics (Ptrend < .001). Standardization for interlaboratory variability did little to alter these results. For women with Ki67 scores of 0%-5%, 6%-10%, 11%-19%, and 20%-29% the corresponding 8-year adjusted cumulative breast cancer mortality risks were 3.3% (95% confidence interval [CI] = 2.8% to 4.0%), 3.7% (95% CI = 3.0% to 4.4%), 3.4% (95% CI = 2.8% to 4.1%), and 3.4% (95% CI = 2.8% to 4.1%), whereas for women with Ki67 scores of 30%-39% and 40%-100%, these risks were higher, at 5.1% (95% CI = 4.3% to 6.2%) and 7.7% (95% CI = 6.6% to 9.1) (Ptrend < .001). Similar results were obtained when the adjusted analysis was repeated with omission of pathological information about tumor size and nodal involvement, which would not be available preoperatively for patients being considered for neoadjuvant therapy. Our findings confirm the prognostic value of Ki67 scores of 30% or more in women with ER-positive, HER2-negative early IBC, irrespective of interlaboratory variability. These results also suggest that Ki67 may be useful to aid decision-making in the neoadjuvant setting.
Sections du résumé
BACKGROUND
The percentage of cells staining positive for Ki67 is sometimes used for decision-making in patients with early invasive breast cancer (IBC). However, there is uncertainty regarding the most appropriate Ki67 cut points and the influence of interlaboratory measurement variability. We examined the relationship between breast cancer mortality and Ki67 both before and after accounting for interlaboratory variability and 8 patient and tumor characteristics.
METHODS
A multicenter cohort study of women with early IBC diagnosed during 2009-2016 in more than 20 NHS hospitals in England and followed until December 31, 2020.
RESULTS
Ki67 was strongly prognostic of breast cancer mortality in 8212 women with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative early IBC (Ptrend < .001). This relationship remained strong after adjustment for patient and tumor characteristics (Ptrend < .001). Standardization for interlaboratory variability did little to alter these results. For women with Ki67 scores of 0%-5%, 6%-10%, 11%-19%, and 20%-29% the corresponding 8-year adjusted cumulative breast cancer mortality risks were 3.3% (95% confidence interval [CI] = 2.8% to 4.0%), 3.7% (95% CI = 3.0% to 4.4%), 3.4% (95% CI = 2.8% to 4.1%), and 3.4% (95% CI = 2.8% to 4.1%), whereas for women with Ki67 scores of 30%-39% and 40%-100%, these risks were higher, at 5.1% (95% CI = 4.3% to 6.2%) and 7.7% (95% CI = 6.6% to 9.1) (Ptrend < .001). Similar results were obtained when the adjusted analysis was repeated with omission of pathological information about tumor size and nodal involvement, which would not be available preoperatively for patients being considered for neoadjuvant therapy.
CONCLUSION
Our findings confirm the prognostic value of Ki67 scores of 30% or more in women with ER-positive, HER2-negative early IBC, irrespective of interlaboratory variability. These results also suggest that Ki67 may be useful to aid decision-making in the neoadjuvant setting.
Identifiants
pubmed: 37567612
pii: 7241520
doi: 10.1093/jncics/pkad054
pmc: PMC10500622
pii:
doi:
Substances chimiques
Ki-67 Antigen
0
Biomarkers, Tumor
0
Receptors, Estrogen
0
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Cancer Research UK
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C8225/A21133
Pays : United Kingdom
Organisme : Cancer Research UK
ID : PRCRPG-NOV21\100001
Pays : United Kingdom
Organisme : Cancer Research UK
ID : RCCCSF-NOV22/100002
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press.
Références
Lancet Oncol. 2020 Nov;21(11):1443-1454
pubmed: 33152284
Nat Rev Clin Oncol. 2017 Oct;14(10):595-610
pubmed: 28561071
NPJ Breast Cancer. 2020 Jun 8;6:21
pubmed: 32550266
Breast Cancer Res Treat. 2020 Jun;181(3):487-497
pubmed: 32333293
BMC Cancer. 2014 Dec 03;14:908
pubmed: 25472026
Mod Pathol. 2019 Jan;32(1):59-69
pubmed: 30143750
Ann Oncol. 2021 Dec;32(12):1571-1581
pubmed: 34656740
Eur J Cancer. 2017 Oct;84:219-227
pubmed: 28829990
NPJ Breast Cancer. 2016 May 18;2:16014
pubmed: 28721378
Breast Cancer (Dove Med Press). 2017 May 29;9:393-400
pubmed: 28615971
J Natl Cancer Inst. 2011 Nov 16;103(22):1656-64
pubmed: 21960707
Mod Pathol. 2021 Jan;34(1):70-76
pubmed: 32740650
Pathology. 2017 Feb;49(2):166-171
pubmed: 28065411
J Clin Oncol. 2011 Nov 10;29(32):4273-8
pubmed: 21990413
Br J Cancer. 2007 May 21;96(10):1504-13
pubmed: 17453008
Breast Cancer Res Treat. 2019 Jul;176(2):377-386
pubmed: 31041683
J Clin Oncol. 2022 Apr 10;40(11):1155-1162
pubmed: 35084948
Lancet Oncol. 2010 Feb;11(2):174-83
pubmed: 20152769
Breast. 2008 Aug;17(4):323-34
pubmed: 18455396
J Natl Cancer Inst. 2021 Jul 1;113(7):808-819
pubmed: 33369635