ArticleBreast cancer research and treatment2016
Optimal Ki67 cut-off for luminal breast cancer prognostic evaluation: a large case series study with a long-term follow-up.
Article in Breast cancer research and treatment, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 112 papers.
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112 citing papers in PubMed.
- A multimodal deep learning classifier for prediction of HER2-low expression in triple-negative breast cancer.BMC medical imaging · 2026Article
- Inter-Observer Reproducibility of [18F]FDG PET/CT Radiomic Features in Primary Breast Carcinoma.Journal of imaging · 2026Article
- Ki67 Gene Expression is Associated with Immune Cell Infiltration and Neoadjuvant Chemotherapy Response in ER+/HER2- Breast Cancer.Annals of surgical oncology · 2026Article
- High TROP-2 expression as a predictor of poor neoadjuvant chemotherapy response in luminal B breast cancer: a retrospective clinicopathological study.BMC cancer · 2026Article
- Investigation of immunohistochemical marker expression in breast cancer of varying severity and construction of a predictive model.Translational cancer research · 2026Article
- Article
- Identifying hormone receptor-positive breast cancer subtypes with recurrence scores derived from pathological data without Ki-67 indices: a clinicopathological study of breast cancer survival in West Asia.Virchows Archiv : an international journal of pathology · 2026Article
- Development and validation of a novel nomogram predicting axillary lymph node metastasis among breast cancer patients in Egypt.Scientific reports · 2026Article
- Survival benefit of neoadjuvant chemotherapy in HR+/HER2- early breast cancer stratified by luminal B status and clinical risk: a real-world cohort study in a Chinese population.Frontiers in oncology · 2026Article
- Deep learning model to predict Ki-67 expression of breast cancer using digital breast tomosynthesis.Breast cancer (Tokyo, Japan) · 2026Article
- Article
- Tumor budding and Ki-67 proliferation index as biomarkers for NAC response and prognosis in breast cancer.Future oncology (London, England) · 2025Article
- Prognosis of Breast Cancer in Women in Their 20s: Clinical and Radiological Insights.Diagnostics (Basel, Switzerland) · 2025Article
- Clinical Significance and Prognostic Value of TLR4 and AGER in Inflammatory Breast Cancer.Cancers · 2025Article
- Molecular Subtypes and Ki-67 index in Breast Carcinoma with Special Emphasis on Triple Negative Breast Cancer. A 3-year Study in a Tertiary Care Center.Indian journal of surgical oncology · 2025Article
- Differences in Clinical, Epidemiological, and Pathological Features of Breast Cancer in the Saudi Population: An Analytical Cross-Sectional Single Institution Study.Healthcare (Basel, Switzerland) · 2025Article
- The association between Ki-67 expression and survival in breast cancer subtypes: a cross-sectional study of Ki-67 cut-point in northern Thailand.BMC cancer · 2025Article
- Magnetic Resonance Elastography of Invasive Breast Cancer: Evaluating Prognostic Factors and Treatment Response.Tomography (Ann Arbor, Mich.) · 2025Article
- Intratumoral heterogeneity of Ki67 proliferation index outperforms conventional immunohistochemistry prognostic factors in estrogen receptor-positive HER2-negative breast cancer.Virchows Archiv : an international journal of pathology · 2025Article
- Preoperative Differentiation of HER2-Zero and HER2-Low from HER2-Positive Invasive Ductal Breast Cancers Using BI-RADS MRI Features and Machine Learning Modeling.Journal of magnetic resonance imaging : JMRI · 2025Article
52 more citing papers are in PubMed but not listed here.
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Abstract
Although Ki67 index suffers from poor reproducibility, it is one of the most important prognostic markers used by oncologists to select the treatment of estrogen receptor (ER) positive breast cancer patients. In this study, we aim to establish the optimal Ki67 cut-offs for stratifying patient prognosis and to create a comprehensive prognostic index for clinical applications. A mono-institutional cohort of 1.577 human epidermal growth factor receptor 2 negative/ER+ breast cancer patients having complete clinical, histological, and follow-up data was collected. The 14 and 20 % Ki67 cut-offs were correlated to disease-free interval (DFI) and disease-specific survival (DSS). To create a comprehensive prognostic index, we used independent variables selected by uni/multivariate analyses. In terms of DFI and DSS, patients bearing tumors with Ki67 < 14 % proliferation index did not differ from those with Ki67 values between 14 and 20 %. Patients with tumor with Ki67 > 20 % showed the poorest prognosis. Moreover, to tumor size, the number of metastatic lymph nodes and Ki67 > 20 % was given a score value, varying depending on definite cut-offs and used to create a prognostic index, which was applied to the population. Patients with a prognostic index ≥3 were characterized by significant risk of relapse [DFI: Hazard Ratio (HR) = 4.74, p < 0.001] and death (DSS: HR = 5.03, p < 0.001). We confirm that the 20 % Ki67 cut-off is the best to stratify high-risk patients in luminal breast cancers, and we suggest to integrate it with other prognostic factors, to better stratify patients at risk of adverse outcome.
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