Original Stage I's with high KI-67 that progressed?

Montana · 06-04-2007, 08:22 AM

My onc has always been concered because of my high KI-67 (35%). I wonder why I didn't get Herceptin if he was so concerned????

In light of the meta-analysis coming out at ASCO..."Ki-67 is present in all proliferating cells and has attracted scientists' interest as a marker of proliferation. It has also featured in several 'proliferation signatures' identified using genetic microarrays.

In the study overall, patients with a Ki-67-positive tumor had a 93% increased risk of relapse and a 95% increased risk of death, compared with Ki-67-negative patients."

I would like to know if there are any of you out there that originally began as Stage I and progressed or recurred?

Sheila · 06-04-2007, 09:25 PM

I was stage one and recurred, the history is in my signature. I will get my lab reports and see what my KI-67 was...seems it was high. I recurred in a year and a half.

Yorkiegirl · 06-05-2007, 06:41 AM

HMM I'm not Stage 1, but Stage 3, and my ki67 is 78%.

Montana · 06-05-2007, 07:57 AM

Thank you Sheila and Yorkiegirl for your input. With the few number of replies, it seems that maybe a high KI-67 doesn't correlate to such high recurrence rates after all...

janet11 · 06-05-2007, 10:33 AM

Well, this isn't much of a scientific survey anyway (*smile*). I figure that it's just 'one more factor' to be considered. It's not a guarantee that it'll recur.

Good luck,
Janet

julierene · 06-05-2007, 10:39 AM

How do you get KI-67 tested?

janet11 · 06-05-2007, 10:50 AM

Mine was just part of the pathology report 'appendix' where they had additional tests to test ER, PR, HER2, and the rest.

Linda · 06-05-2007, 11:07 AM

Hi Montana -- I'm another who had a through-the-roof ki67 -- mine was 90%!! and stage 3a. My tumor did grow FAST. But that was two years ago, and I'm NED.
I've read that ki67 is not that accurate. I wouldn't worry about it, if I were you.
Linda

Becky · 06-06-2007, 07:03 PM

Also, think of it this way. Let's say at your Stage that you have a 10% chance of recurring and if your Ki-67 is high, you said you have a 93% greater chance of recurrence so now your chance of recurrence is 19.3% - Still an over 80% chance of NOT recurring. Still GREAT odds. Not as good as 100% but then, everybody dies one day so nothing is 100%

Have a great Thursday.

06-06-2007, 07:40 PM

Is there such a thing as a negative Ki67? That is, are there women with breast cancer with a Ki 67 of 0. I thought it was a sliding scale, and that anyone with a Ki67 below 15 had a low proliferation rate, that from 15 to 25% was considered medium, and above 25%, high. One of the radiologists I went to see early on, told me he thought anything above 35% was high. I do remember reading somewhere that in the Milan Breast Center, they consider anything above 19% high. But it's so long ago. Can anyone answer about the "negative" Ki67. Thanks.

Hopeful · 06-07-2007, 05:13 AM

Grace,

Here is a link to an article I posted about a mega analysis of KI-67 in the articles forum: http://her2support.org/vbulletin/sho...rid=1173<br />

Different studies use different cut-off points for different purposes. The lowest cut-off point I have seen is 10% for "positive." The author of the article says that is probably a good cut-off point for consideration of chemotherapy (i.e., below 10% and the returns on toxicity are greatly diminished). My Ki-67 was 11%, described as "borderline" on my path report. It did weigh into my decision to skip chemo.

Hopeful

Alice · 06-07-2007, 10:26 PM

This is all very interesting. I would like to read more about this. Sometimes though, I think that we pick things apart too much. Just the stress of wondering what causes this and what causes that can be overwhelming in itself. My score for the Ki67 was 90%. I wonder what correlation the P53 has. It was also 90%.

Well have a good evening!
Alice

shelli · 06-07-2007, 11:19 PM

I think I may get the prize for the highest ki67 at 94%, I live in Vegas & don''t
gamble, but sure wish I could have won something better! What are other
tests like P53, TOPO II, etc. Not familiar with them. Was DX. 5/05 and now
going through every test/scan possible to ensure I'm in remission. Finished
Herceptin X52 wks. l/07. Body bone scan next Mon. otherwise 2-2mm. nodules on CT chest - will redo CT in 3mos., PET fine, Brain MRI showed a
benign tumor called a venous angioma (not going to worry about it), liver
2mm nodule & enlargement (was there before CA so not going to worry about
it either. Having soreness/bruised feeling in RT. hip X6 mos. so will check on
bone scan results. Also have Osteoporosis. Are there any other tests that are
new & reflect more in pathology in past 2 yrs.? In the mean time life is a
gamble & all we can do is hope we get the good coin toss! I vasilate between
worrying about the stats. but we never really know which part of that margin
we will land on! I'm trying to stay positive and redirect my focus now on helping others.

Lani · 06-08-2007, 12:03 AM

if you were premenopausal when you were diagnosed.

If so, one's Ki-67 varies with the phase of the menstrual cycle you might have been in when you were operated.

shelli · 06-08-2007, 01:09 AM

Hi Lani, thanks for asking. I was DX in 2005 at 5l yrs. old but went into complete early menopause at 42 so menopausal for almost 10 yrs. upon CA
diagnosis. Its interesting though, I never knew there was a correlation.Thank you for the information.

Lani · 06-08-2007, 03:10 AM

1: Virchows Arch. 2007 Jun 7; [Epub ahead of print]
Ki-67 expression in primary breast carcinomas and their axillary lymph node metastases: clinical implications.

Park D, Kåresen R, Noren T, Sauer T.
Department of Pathology, Ullevaal University Hospital, Kirkeveien 166, N-0407, Oslo, Norway, daehoon.park@ulleval.no.
Proliferative activity of tumour cells assessed by immunohistochemical Ki-67 expression is one of several prognostic indicators in breast cancer. The major objective of this study was to investigate the prognostic impact of Ki-67 proliferative activity in the axillary lymph node metastases and in the matched primary breast carcinoma from 194 patients. There was a statistically significant up-regulation of Ki-67 protein in the metastatic deposit compared to where the primary tumour was found (p = 0.001). A low Ki-67 index in both the primary and the metastatic tumours was a favorable prognostic factor. A high index in both primary and metastatic lesion and an up-regulation from a low index in the primary tumour to a high index in the metastatic deposit represented an unfavorable prognostic factor. Multivariate analysis showed that Ki-67 expression in the metastases was a superior independent prognostic factor of clinical outcomes compared to that in the primary tumours. Ki-67 expression in >/=10% of carcinoma cells in the primary tumours and >/=15% in the nodal metastases seems to be optimal cut-off levels. Ki-67 is of value as an independent prognostic factor in breast cancer.
PMID: 17554555 [PubMed - as supplied by publisher]

Hopeful · 06-08-2007, 09:42 AM

In addition to being a prognostic factor, I have read studies that consider Ki-67 predictive for response to certain therapies, like AI's and chemo. The biggest problem seems to be a lack of standardization for testing (ala her2 a few years ago).

Hopeful

CLTann · 06-08-2007, 02:44 PM

What is KI67? I have never heard of this test. I looked back my path report and found nothing mentioned about KI67. In order to find out where I stand, is it now too late (21 month after mastectomy) to do the test? Is it better to let the issue un-answered?

shelli · 06-08-2007, 03:18 PM

The ki67 has to do with the proliferation rate (unruly growth/agressiveness) of the cells of the tumor. It is looked upon with other prognostic factors of how a tumor behaves and helps Docs determine best treatment course / how agressive to be with chemo/etc. and predicted outcomes. Again, its still a guessing game with statistics. If the lab still has your original Biopsy or surgical pathology slides which they are required to maintain for several years then they may be able to still test for this. I don't know the specific details but speak to your Doc & Path. lab to determine the feasability.
Good Luck!

Adriana Mangus · 06-08-2007, 03:37 PM

Dear Montana: My returned almost 10 years after, what I hear is that 50% of all bc will return, no matter what. Is just a matter of time. I did not know anything about HER2 since I was initially dx in 94 and there was no test for it.

KI-67? Maybe the onc knows mine, but I do not remember him discussing any
KI with me. What is it? Is this a type of gene? Can I have it done now-does it matter?

Thanks to all who take the time to answer this question.

With much love.