Evidence map›Paper›PMID 39476005›Full record

ArticleArchives of gynecology and obstetrics2025

Can Ki-67 serve as a suitable marker to indicate the necessity of staging diagnostics in cases of low-risk breast cancer?

Lisa Jung, Sarah Isabelle Huwer, Peter Jungmann, Markus Medl, Florin-Andrei Taran, Jakob Neubauer, Carolin Wilpert, Ingolf Juhasz-Böss, Carolin Müller

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Article in Archives of gynecology and obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lisa JungDepartment of Obstetrics and Gynecology at the Medical Center, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany. lisa.jung@uniklinik-freiburg.de.
Sarah Isabelle HuwerDepartment of Obstetrics and Gynecology at the Medical Center, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
Peter JungmannDepartment of Obstetrics and Gynecology at the Medical Center, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
Markus MedlDepartment of Obstetrics and Gynecology at the Medical Center, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
Florin-Andrei TaranDepartment of Obstetrics and Gynecology at the Medical Center, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
Jakob NeubauerDepartment of Radiology, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
Carolin WilpertDepartment of Radiology, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany.
Ingolf Juhasz-BössDepartment of Obstetrics and Gynecology at the Medical Center, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.ORCID 0000-0002-2178-6490
Carolin MüllerDepartment of Obstetrics & Gynecology, Saarland University Medical Center, University of Saarland, Homburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor many years, staging tests have not been routinely employed for low-risk early breast cancer (EBC). However, the role of Ki-67 in determining the need for staging tests in low-risk EBC remains unclear. Our study aimed to assess the number and types of staging diagnostics, additional imaging, false-positive results, and rate of distant metastases in low-risk EBC with low and high Ki-67 (< / ≥ 25%).

methodsThis is a retrospective, single institution cohort study. All patients with newly diagnosed low-risk breast cancer at the University Medical Center in Freiburg in 2017 and 2021 were included. Low-risk was defined as clinical tumor stage T1/2, node negative (N0), hormone receptor positive, HER2 negative, asymptomatic EBC. Information on demographics, clinical and pathological characteristics, as well as number and type of performed staging diagnostics was obtained. Rate and type of additional imaging or follow-up diagnostics due to suspicious findings was analyzed. The patients were divided into two groups (Ki-67 < and ≥ 25%) and rates of distant metastases, performed staging diagnostics and false positive rates were compared.

resultsA total of 189 patients with low-risk EBC were identified, with 54% (n = 102) having Ki-67 < 25% and 46% (n = 87) having Ki-67 ≥ 25%. Risk for distant metastases was 0% in Ki-67 < 25% and 1.1% in patients with Ki-67 ≥ 25% (p = 0.46). Due to suspicious findings in the initial staging diagnostic, additional imaging was required for 11.8% (n = 12) of patients with Ki-67 < 25% compared to 19.5% (n = 17) of patients with Ki-67 ≥ 25% (p = 0.16). False positive rates did not differ significantly between the two groups (7.6% in Ki-67 < 25% vs. 9.8% in Ki-67 ≥ 25%; p = 0.55).

conclusionDistant metastases are rare in low-risk EBC. All in all, staging diagnostics should not be routinely employed in this patient population. Only patients with high Ki-67 developed distant metastases. In these cases, staging diagnostics may be discussed with the patient.

Indexed as

Biomarkers, TumorBreast NeoplasmsKi-67 AntigenAdultAgedFalse Positive ReactionsFemaleHumansMiddle AgedNeoplasm StagingRetrospective StudiesBiomarkers, TumorKi-67 AntigenBreast cancerDiagnosticsDistant metastasesKi-67Low riskStaging

Identifiers

PMID39476005
PMCPMC11890247

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.