title: Prognostic and predictive value of Ki-67 in triple-negative breast cancer.
abstract: This study was to investigate the prognostic role of Ki-67 in further classification of triple negative breast cancer (TNBC), and to test whether high expression level of Ki67 can predict benefit from carboplatin. From January 2004 to December 2012, 363 patients operated for TNBC were identified through the institutional clinical database. After a median follow-up time of 34 months (5.2-120.0 months), 62 patients (17.1%) had relapses and 33 patients (9.1%) died of breast cancer. In univariate analysis, high Ki-67 index as well as larger tumor size and lymph node involvement was associated with shorter disease-free survival (DFS) and overall survival (OS). In multivariate analysis, high Ki-67 is an independent risk factor for DFS (Risk Ratio, RR: 2.835, 95% confidence interval, 95% CI: 1.586-5.068, P < 0.001) and OS (RR: 3.180, 95% CI: 1.488-6.793, P = 0.003). When analyzing the 3-year DFS by Ki-67 distribution, Subpopulation Treatment Effect Pattern Plot analysis showed a beneficial effect of carboplatin in patients with high Ki-67 index. In conclusion, TNBC is probably a heterogeneous disease with different characteristics and prognosis, and may be further subdivided according to the Ki-67 expression levels. Patients in the high Ki- 67 group seem to benefit more from treatment with carboplatin, but this needs to be further verified.
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Jiayi
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Information Engineering, Shanghai Jiaotong University, Shanghai 200240, P.R. China.
authors.forename: Peifeng
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Pathology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Fei
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zong
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Xiaosong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Ou
authors.initials: O
authors.lastname: Huang
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: He
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Chen
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Yafen
authors.initials: Y
authors.lastname: Li
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Kunwei
authors.initials: K
authors.lastname: Shen
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016190:Carboplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000096:biosynthesis*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult
chemical_list: D019394:Ki-67 Antigen; D016190:Carboplatin
keywords: breast carcinoma; hormonal receptor negativity; human epithelial growth factor receptor 2 negativity; platinum; proliferation index