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Hi Hopeful,
The research showed that Ki67 expression after short term endocrine treatment may improve the predicition of recurrence free survival.
As far as the estrogen being downregulated by the hormone therapy I am not
sure that is what the article is representing. Maybe this is why the question
of chemo treatment comes into play, meaning that AI or Tamoxifen treatment is not the best course of action for a tumor that has a high Ki67 level. They say it "may improve" recurrence free survival. This also ties in with the Oncotype DX test where a patient is on the fence with a treatment choice. This article is saying that pre-surgical therapy did not enhance recurrence free survival but rather it was worse. Hence maybe chemo should be applied. Maybe I am reading this wrong but that is what I have gotten out of the article. They need to do additional testing. I do know that when the Ki67 levels are high that is often the ticket to chemo. (at least when I met with Dr. Slamon he discussed with me my Ki67 level and this was a strong factor.)
Regards,
Jean
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Stage 1, Grade 1, 3/30/05
Lumpectomy 4/15/05 - 6MM IDC
Node Neg. (Sentinel node)
ER+ 90% / PR-, Her2+++ by FISH
Ki-67 40%
Arimidex 5/05
Radiation 32 trt, 5/30/05
Oncotype DX test 4/17/06, 31% high risk
TOPO 11 neg. 4/06
Stopped Arimidex 5/06
TCH 5/06, 6 treatments
Herceptin 5/06 - for 1 yr.
9/06 Completed chemo
Started Femara Sept. 2006
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