The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up

Augusto Lombardi, Rachele Lazzeroni, Laura Bersigotti, Valeria Vitale, Claudio Amanti Department of Breast Surgery, Università di Roma La Sapienza – OspedaleSant’Andrea, Rome, ItalyCorrespondence: Laura BersigottiOspedaleSant’Andrea, via di Grottarossa 1035,...

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Autores principales:	Lombardi A, Lazzeroni R, Bersigotti L, Vitale V, Amanti C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	ki67 molecular subtypes immunohistochemistry Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/208262ef2da744348379312eb56dacc9
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spelling	oai:doaj.org-article:208262ef2da744348379312eb56dacc92021-12-02T18:13:26ZThe Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up1179-1314https://doaj.org/article/208262ef2da744348379312eb56dacc92021-04-01T00:00:00Zhttps://www.dovepress.com/the-proper-ki-67-cut-off-in-hormone-responsive-breast-cancer-a-monoins-peer-reviewed-article-BCTThttps://doaj.org/toc/1179-1314Augusto Lombardi, Rachele Lazzeroni, Laura Bersigotti, Valeria Vitale, Claudio Amanti Department of Breast Surgery, Università di Roma La Sapienza – OspedaleSant’Andrea, Rome, ItalyCorrespondence: Laura BersigottiOspedaleSant’Andrea, via di Grottarossa 1035, Rome, 00189, ItalyTel +39 3332559243Fax +39 06 33775649Email laufeberj@hotmail.itIntroduction: Breast cancer is a heterogeneous disease. Our study focuses on a monoinstitutional series of patients affected by Hormone Responsive carcinomas (luminal A and luminal B) and aims to define an optimal Ki-67 cut-off, to correctly stratify these patients into risk classes, using the ImmunoHistoChemical (IHC) surrogates of the Molecular Subtypes, according to the St. Gallen guidelines.Methods: We analyzed 1685 patients. These patients underwent both radical and conservative surgeries with Sentinel Lymph Node Biopsy eventually followed by Axillary Dissection (AD). Furthermore, all the patients underwent adjuvant therapies according to the guidelines. A retrospective univariate analysis was performed and survival curves (Disease-Related Survival, DRS, and Disease-Free Survival, DFS) were carried out according to the following ki-67 risk classes: Low Risk (Ki-67 ≤ 14%); Intermediate Risk (Ki-67 15% ÷ 20%); High Risk (Ki-67 > 20%).Results: 14 yy DRS was 98% in LA and 85% in LB with a ki-67 cut-off of 14% (p=0.037) vs 95% (LA) and 83% (LB) with a ki-67 cut-off of 20% (p=0.003). 14yy DFS was 85% in LA and 72% in LB with a ki-67 cut-off of 14% (p=0.017) vs 83% (LA) and 66% (LB) with a ki-67 cut-off of 20% (p< 0.000).Discussion: Our results confirmed that the 20% Ki-67 cut-off is more reliable in differentiating patients at low or high risk of recurrence and death, and stratifying patients eligible for adjuvant chemotherapy. Thus, despite its poor reproducibility, the identification of the most accurate ki-67 index assumes a pivotal relevance in guiding a tailored strategy among patients with this specific profile of breast cancer, as well as the molecular surrogates, in order to avoid harmful overtreatments.Keywords: Ki67, molecular subtypes, immunohistochemistryLombardi ALazzeroni RBersigotti LVitale VAmanti CDove Medical Pressarticleki67molecular subtypesimmunohistochemistryNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol Volume 13, Pp 213-217 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ki67 molecular subtypes immunohistochemistry Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	ki67 molecular subtypes immunohistochemistry Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Lombardi A Lazzeroni R Bersigotti L Vitale V Amanti C The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up
description	Augusto Lombardi, Rachele Lazzeroni, Laura Bersigotti, Valeria Vitale, Claudio Amanti Department of Breast Surgery, Università di Roma La Sapienza – OspedaleSant’Andrea, Rome, ItalyCorrespondence: Laura BersigottiOspedaleSant’Andrea, via di Grottarossa 1035, Rome, 00189, ItalyTel +39 3332559243Fax +39 06 33775649Email laufeberj@hotmail.itIntroduction: Breast cancer is a heterogeneous disease. Our study focuses on a monoinstitutional series of patients affected by Hormone Responsive carcinomas (luminal A and luminal B) and aims to define an optimal Ki-67 cut-off, to correctly stratify these patients into risk classes, using the ImmunoHistoChemical (IHC) surrogates of the Molecular Subtypes, according to the St. Gallen guidelines.Methods: We analyzed 1685 patients. These patients underwent both radical and conservative surgeries with Sentinel Lymph Node Biopsy eventually followed by Axillary Dissection (AD). Furthermore, all the patients underwent adjuvant therapies according to the guidelines. A retrospective univariate analysis was performed and survival curves (Disease-Related Survival, DRS, and Disease-Free Survival, DFS) were carried out according to the following ki-67 risk classes: Low Risk (Ki-67 ≤ 14%); Intermediate Risk (Ki-67 15% ÷ 20%); High Risk (Ki-67 > 20%).Results: 14 yy DRS was 98% in LA and 85% in LB with a ki-67 cut-off of 14% (p=0.037) vs 95% (LA) and 83% (LB) with a ki-67 cut-off of 20% (p=0.003). 14yy DFS was 85% in LA and 72% in LB with a ki-67 cut-off of 14% (p=0.017) vs 83% (LA) and 66% (LB) with a ki-67 cut-off of 20% (p< 0.000).Discussion: Our results confirmed that the 20% Ki-67 cut-off is more reliable in differentiating patients at low or high risk of recurrence and death, and stratifying patients eligible for adjuvant chemotherapy. Thus, despite its poor reproducibility, the identification of the most accurate ki-67 index assumes a pivotal relevance in guiding a tailored strategy among patients with this specific profile of breast cancer, as well as the molecular surrogates, in order to avoid harmful overtreatments.Keywords: Ki67, molecular subtypes, immunohistochemistry
format	article
author	Lombardi A Lazzeroni R Bersigotti L Vitale V Amanti C
author_facet	Lombardi A Lazzeroni R Bersigotti L Vitale V Amanti C
author_sort	Lombardi A
title	The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up
title_short	The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up
title_full	The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up
title_fullStr	The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up
title_full_unstemmed	The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up
title_sort	proper ki-67 cut-off in hormone responsive breast cancer: a monoinstitutional analysis with long-term follow-up
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/208262ef2da744348379312eb56dacc9
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The Proper Ki-67 Cut-Off in Hormone Responsive Breast Cancer: A Monoinstitutional Analysis with Long-Term Follow-Up

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