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High Ki-67 expression is associated with increased risk of distant recurrence in Oncotype Dx low risk breast cancer
Journal article   Open access   Peer reviewed

High Ki-67 expression is associated with increased risk of distant recurrence in Oncotype Dx low risk breast cancer

Soumaya Labidi, Nasser Mulla, Islam E. Elkholi, Mariana Pilon Capella, April A.N. Rose, Lawrence Panasci, Cristiano Ferrario, Mark Basik and Parvaneh Fallah
Clinical breast cancer, Vol.25(6), pp.e690-e696.e1
08/01/2025
DOI: 10.1016/j.clbc.2025.04.001
PMID: 40319004
url
https://doi.org/10.1016/j.clbc.2025.04.001View
Published (Version of record) Open Access

Abstract

To assess whether high Ki-67 protein expression level could independently predict the distant recurrence in early-stage breast cancer with low Oncotype Dx scores (≤ 25). This single-center retrospective cohort study included 278 patients with hormone receptor positive (HR+) human epidermal growth factor receptor 2 negative (HER2-), T1-2N0M0, low Oncotype Dx recurrence score (RS) (≤ 25) breast cancer. We identified 2 groups: “high Ki-67″ ≥ 15% (n = 130, 47%) and “low Ki-67″ < 15% (n = 148, 53%). Clinical characteristics, treatment and survival were abstracted from chart review. Fisher’s exact test was used to assess differences between Ki-67 groups. Cox-regression models were used to assess differences in survival. After a median follow up of 7 years, 13 (4.7%) patients experienced distant metastasis. Recurrence rate was significantly higher in the “high Ki-67″ group 9.2% (12/130) versus the “low Ki-67″ group 0.7% (1/148) (P = .001). Distant metastasis-free survival (dMFS) was significantly shorter in the “high Ki-67″ group (HR 12.90, 95% CI, 12.53-13.27, P = .008). Tumor size ≥ 2 cm was associated with shorter dMFS (HR, 12.90; 95% CI, 12.53-13.27; P < .001). In a multivariable analysis, tumor size ≥ 2 cm and “High Ki-67″ were independent prognosis factors for dMFS. Ki-67 expression level may help to identify a subset of low risk Oncotype Dx patients who could benefit from adjuvant chemotherapy. Oncotype Dx recurrence score is a molecular signature to predict the benefit of adjuvant chemotherapy to reduce the risk of recurrence in HR+HER2- breast cancer. We performed a single-center retrospective study of low Oncotype Dx breast cancer patients to determine whether a high Ki-67 ≥ 15% could independently predict distant recurrence. We found a significantly higher recurrence rate, and shorter distant-metastases free survival in this group.
 Chemotherapy Metastasis Early breast cancer Ki-67 Recurrence score

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