Cahyono, Chemy Wiryawan and Budijitno, Selamat (2024) Ki-67 (+) > 20% and HER2-Negative as a Predictor of Recurrence and Progression in Patients with Breast Cancer at Dr. Kariadi General Hospital Semarang 2024. Masters thesis, Universitas Diponegoro.

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Abstract

Background: Cancer is a multifactorial disease in molecular changes lead to uncontrolled cell growth and proliferation. Breast cancers are the most frequent malignancy among women that can be a leading cause of death through middle-aged women, with HER2-negative represents the most common invasive cancer subtype. Uncontrolled proliferation (such as Ki-67) is a key characteristic of malignant tumors and, therefore, tumor proliferation that can be predict from its size is one of the major factors associated with prognosis.
Methods: A retrospective analytic observational study employing a cross-sectional design approach among 94 patients who were selected through total sampling was carried out at RSUP Dr. Kariadi from January to February 2024. Variable assessed in this study include immunohistochemical profile and subtype of patients, the human epidermal growth factor receptor 2 (HER2)-type in breast cancer, Ki-67 index, type of therapy given; and size (volume) of breast cancer. Data were analysed using SPSS version 25.0 for Windows.
Results: Most of respondents had Luminal B-type breast cancer (50.0%), Ki-67 >20% (77.7%), in first line chemotherapy (56.4%), and had 1017.20 ± 1354.59 cm2 of average tumor size. HER2-negative has no significant correlation with the therapy given (p = 0.131) nor the size of breast cancer (p = 0.467). Ki-67 >20% also has no significant correlation with the therapy given (p = 0.070) nor the size of breast cancer (p = 0.156).
Discussion: In this study, higher Ki-67 expression was more frequently associated with HER2-negative and larger tumors. A number of studies reported that a higher Ki-67 index significantly correlated with larger tumors. But in our study, there is a no significant correlation between tumor size with Ki-67 >20% and HER2-negative. There is also no significant correlation between Ki-67 >20% and HER2-negative with type of chemotherapy. Elevated Ki-67 is associated with the high proliferating cells resulted in larger tumor. Meanwhile, chemotherapy agents are effectively targeting the cancer cells which are in the proliferation phase.
Conclusion: There is no significant correlation between Ki-67 >20% and HER2-negative with type of chemotherapy as well as tumor size. This is due to chemotherapy agents are effectively targeting the cancer cells which are in the proliferation phase, meanwhile Ki-67 >20% is associated as a predictive factor and possible effects on progression and recurrence.

Keywords: Ki-67, HER2-negative, Recurrence, Progression, Breast Cancer

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