title: Evaluation of Tumor Cell Proliferation by Ki-67 Expression and Mitotic Count in Lymph Node Metastases from Breast Cancer.
abstract: Few studies have addressed the risk of recurrence by assessing proliferation markers in lymph node metastasis from breast cancer. Here, we aimed to examine Ki-67 expression and mitotic count in lymph nodes in comparison with primary tumors. A cohort of node positive breast cancer (n = 168) was studied as a part of the prospective Norwegian Breast Cancer Screening Program (1996-2009). The percentage of Ki-67 positivity was counted per 500 tumor cells in hot-spot areas (x630). Mitotic count was conducted in the most cellular and mitotic active areas in 10 high power fields (x400). Our results showed that Ki-67 and mitotic count were significantly correlated between primary tumor and lymph nodes (Spearman`s correlation 0. 56 and 0.46, respectively) and were associated with most of the histologic features of the primary tumor. Univariate survival analysis (log-rank test) showed that high Ki-67 and mitotic count in the primary tumor and lymph node metastasis significantly predicted risk of recurrence. In multivariate analysis, mitotic count in the lymph node metastasis was an independent predictor of tumor recurrence. In conclusion, proliferation markers in lymph node metastases significantly predicted disease free survival in node positive breast cancer.
authors.affiliation: Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Sura
authors.initials: S
authors.lastname: Aziz
authors.affiliation: Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Wik
authors.affiliation: Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Gøril
authors.initials: G
authors.lastname: Knutsvik
authors.affiliation: Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.|Department of Pathology, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Tor Audun
authors.initials: TA
authors.lastname: Klingen
authors.affiliation: Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.|Department of Pathology, Akerhus University Hospital, Lørenskog, Norway.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Surgery, Haukeland University Hospital, Bergen, Norway.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Davidsen
authors.affiliation: Department of Surgery, Vestfold Hospital Trust, Tønsberg, Norway.
authors.forename: Hans
authors.initials: H
authors.lastname: Aas
authors.affiliation: Department of Surgery, Haukeland University Hospital, Bergen, Norway.
authors.forename: Turid
authors.initials: T
authors.lastname: Aas
authors.affiliation: Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway.|Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Lars A
authors.initials: LA
authors.lastname: Akslen
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D049109:Cell Proliferation; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000235:genetics / Q000378:metabolism*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D008940:Mitotic Index; D060787:Neoplasm Grading; D063868:Patient Outcome Assessment; D011379:Prognosis; D016016:Proportional Hazards Models; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen