Evidence map›Paper›PMID 42773315›Full record

ArticleBreast cancer research and treatment2026

Ki-67 expression and rates of pathologic complete response in T1cN0M0 triple-negative breast cancer: a national cancer database analysis.

Andrew Venardi, Fatemeh Shojaeian, Sophia Diaz, Calvin R Schuster, Piyush Rath, Ishrar Shaid, Ambika Singh, Cesar Santa-Maria, Olutayo Sogunro

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Article in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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9 authors.

Andrew VenardiDivision of Breast Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. asvenardi@gmail.com.ORCID http://orcid.org/0000-0003-3097-8299
Fatemeh ShojaeianDivision of Breast Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sophia DiazDivision of Breast Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Calvin R SchusterDivision of Breast Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Piyush RathJohns Hopkins University, Baltimore, MD, USA.
Ishrar ShaidEdward Via College of Osteopathic Medicine, Monroe, LA, USA.
Ambika SinghDr Kiran C Patel College of Osteopathic Medicine at Nova Southeastern University, Davie, FL, USA.
Cesar Santa-MariaDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Olutayo SogunroDivision of Breast Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTreatment sequencing for T1cN0M0 triple-negative breast cancer (TNBC) remains controversial because neoadjuvant chemotherapy (NACT) has not demonstrated improved overall survival (OS) compared to adjuvant chemotherapy (ACT). Using pathologic complete response (pCR) as an early, positive prognostic indicator, this study evaluates how Ki-67 expression levels impact pCR rates in T1cN0M0 TNBC to identify patients who benefit most from upfront chemotherapy.

methodsThe National Cancer Database (NCDB) was queried (2018-2022) for female patients aged ≥ 18 with T1N0M0 TNBC undergoing chemotherapy and surgery. Patients were grouped into NACT or ACT cohorts and balanced using inverse probability of treatment weighting (IPTW). Cox multivariate analysis evaluated OS predictors, while logistic regression identified factors associated with pCR. A ROC curve was created for Ki-67 expression in the setting of pCR and the maximum Youden index established a threshold value.

resultsAn analysis of 8,831 patients from the NCDB found no significant difference in OS between NACT and ACT, but multivariate analysis revealed lymphovascular invasion (LVI), invasive lobular subtype (ILC), and mixed invasive lobular/ductal subtype were associated with worse OS. In the NACT group, there was a 3.59 h for worse OS in non-pCR patients compared to those achieving pCR. Ki-67 expression was strongly associated with pCR rates, with Ki-67 ≥ 45.8% yielding a 45.3% pCR rate compared to 21.8% for Ki-67 < 45.8%.

conclusionAlthough OS did not differ between NACT and ACT in T1cN0M0 TNBC, achieving pCR after NACT significantly improved survival. A Ki-67 threshold of ≥ 45.8% predicted higher pCR rates and can guide patient selection for upfront chemotherapy. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Biomarkers, TumorKi-67 AntigenTriple Negative Breast NeoplasmsAdultAgedChemotherapy, AdjuvantDatabases, FactualFemaleHumansMiddle AgedNeoadjuvant TherapyNeoplasm StagingPathologic Complete ResponsePrognosisBiomarkers, TumorKi-67 AntigenEarly stage breast cancerKi-67 expression levelsNeoadjuvant chemotherapyPathologic complete responseTriple negative breast cancer

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PMID42773315

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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.