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Patterns of Relapse Related to High Expression of Ki-67 After Neoadjuvant Chemotherapy in Triple Negative Breast Cancer

Received: 3 August 2021    Accepted: 17 August 2021    Published: 4 September 2021
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Abstract

Introduction: Triple negative breast cancer (TNBC) has been classically considered a high-risk subtype. Early TNBC is usually managed with neoadjuvant chemotherapy (NAC). Residual disease after NAC is generally considered a surrogate marker for event free survival in these patients. The aim of this study was to explore the relationship between high Ki-67 expression in residual disease after NAC and disease relapse. Material and methods: This is a retrospective study of 121 patients diagnosed with TNBC, treated with neoadjuvant chemotherapy in our institution between 2008 and 2018. Clinical features, systemic and surgical therapy and pathological response were analyzed. Ki-67 expression was performed in the post-NAC surgical specimens when a pathological complete response (pCR) was not achieved. Results were correlated with number and type of relapse, and survival. Results: Eighty-one patients (67%) achieved a pCR with a median Ki-67 expression in the residual tumor of 22.5%. Thirteen patients (10.7%) relapsed and all of them belonged to the non-pCR group. In the non-relapse group, the median Ki-67 in the residual tumor was 10% compared to 40% found in the relapse group. (P=0.025). Median Ki-67 post NAC was 70% in those patients who developed a central nervous disease (CNS) relapse, 40% if was a nodal or bone recurrence and 28% if it was a visceral relapse. CNS recurrence was significantly associated with higher Ki-67 levels post NAC (P=0.010). Conclusions: Our results suggest that high expression levels of Ki-67 post-NAC could define different patterns of relapse in TNBC patients treated with NAC.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 5)
DOI 10.11648/j.jgo.20210905.11
Page(s) 139-144
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Triple Negative Breast Cancer, Ki-67, Neoadjuvant Chemotherapy, Relapse, Central Nervous System

References
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Cite This Article
  • APA Style

    Gines Hernandez-Cortes, Javier Hornedo, Raquel Murillo, Ricardo Sainz De La Cuesta, Lucia Gonzalez-Cortijo. (2021). Patterns of Relapse Related to High Expression of Ki-67 After Neoadjuvant Chemotherapy in Triple Negative Breast Cancer. Journal of Gynecology and Obstetrics, 9(5), 139-144. https://doi.org/10.11648/j.jgo.20210905.11

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    ACS Style

    Gines Hernandez-Cortes; Javier Hornedo; Raquel Murillo; Ricardo Sainz De La Cuesta; Lucia Gonzalez-Cortijo. Patterns of Relapse Related to High Expression of Ki-67 After Neoadjuvant Chemotherapy in Triple Negative Breast Cancer. J. Gynecol. Obstet. 2021, 9(5), 139-144. doi: 10.11648/j.jgo.20210905.11

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    AMA Style

    Gines Hernandez-Cortes, Javier Hornedo, Raquel Murillo, Ricardo Sainz De La Cuesta, Lucia Gonzalez-Cortijo. Patterns of Relapse Related to High Expression of Ki-67 After Neoadjuvant Chemotherapy in Triple Negative Breast Cancer. J Gynecol Obstet. 2021;9(5):139-144. doi: 10.11648/j.jgo.20210905.11

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  • @article{10.11648/j.jgo.20210905.11,
      author = {Gines Hernandez-Cortes and Javier Hornedo and Raquel Murillo and Ricardo Sainz De La Cuesta and Lucia Gonzalez-Cortijo},
      title = {Patterns of Relapse Related to High Expression of Ki-67 After Neoadjuvant Chemotherapy in Triple Negative Breast Cancer},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {5},
      pages = {139-144},
      doi = {10.11648/j.jgo.20210905.11},
      url = {https://doi.org/10.11648/j.jgo.20210905.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210905.11},
      abstract = {Introduction: Triple negative breast cancer (TNBC) has been classically considered a high-risk subtype. Early TNBC is usually managed with neoadjuvant chemotherapy (NAC). Residual disease after NAC is generally considered a surrogate marker for event free survival in these patients. The aim of this study was to explore the relationship between high Ki-67 expression in residual disease after NAC and disease relapse. Material and methods: This is a retrospective study of 121 patients diagnosed with TNBC, treated with neoadjuvant chemotherapy in our institution between 2008 and 2018. Clinical features, systemic and surgical therapy and pathological response were analyzed. Ki-67 expression was performed in the post-NAC surgical specimens when a pathological complete response (pCR) was not achieved. Results were correlated with number and type of relapse, and survival. Results: Eighty-one patients (67%) achieved a pCR with a median Ki-67 expression in the residual tumor of 22.5%. Thirteen patients (10.7%) relapsed and all of them belonged to the non-pCR group. In the non-relapse group, the median Ki-67 in the residual tumor was 10% compared to 40% found in the relapse group. (P=0.025). Median Ki-67 post NAC was 70% in those patients who developed a central nervous disease (CNS) relapse, 40% if was a nodal or bone recurrence and 28% if it was a visceral relapse. CNS recurrence was significantly associated with higher Ki-67 levels post NAC (P=0.010). Conclusions: Our results suggest that high expression levels of Ki-67 post-NAC could define different patterns of relapse in TNBC patients treated with NAC.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Patterns of Relapse Related to High Expression of Ki-67 After Neoadjuvant Chemotherapy in Triple Negative Breast Cancer
    AU  - Gines Hernandez-Cortes
    AU  - Javier Hornedo
    AU  - Raquel Murillo
    AU  - Ricardo Sainz De La Cuesta
    AU  - Lucia Gonzalez-Cortijo
    Y1  - 2021/09/04
    PY  - 2021
    N1  - https://doi.org/10.11648/j.jgo.20210905.11
    DO  - 10.11648/j.jgo.20210905.11
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 139
    EP  - 144
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20210905.11
    AB  - Introduction: Triple negative breast cancer (TNBC) has been classically considered a high-risk subtype. Early TNBC is usually managed with neoadjuvant chemotherapy (NAC). Residual disease after NAC is generally considered a surrogate marker for event free survival in these patients. The aim of this study was to explore the relationship between high Ki-67 expression in residual disease after NAC and disease relapse. Material and methods: This is a retrospective study of 121 patients diagnosed with TNBC, treated with neoadjuvant chemotherapy in our institution between 2008 and 2018. Clinical features, systemic and surgical therapy and pathological response were analyzed. Ki-67 expression was performed in the post-NAC surgical specimens when a pathological complete response (pCR) was not achieved. Results were correlated with number and type of relapse, and survival. Results: Eighty-one patients (67%) achieved a pCR with a median Ki-67 expression in the residual tumor of 22.5%. Thirteen patients (10.7%) relapsed and all of them belonged to the non-pCR group. In the non-relapse group, the median Ki-67 in the residual tumor was 10% compared to 40% found in the relapse group. (P=0.025). Median Ki-67 post NAC was 70% in those patients who developed a central nervous disease (CNS) relapse, 40% if was a nodal or bone recurrence and 28% if it was a visceral relapse. CNS recurrence was significantly associated with higher Ki-67 levels post NAC (P=0.010). Conclusions: Our results suggest that high expression levels of Ki-67 post-NAC could define different patterns of relapse in TNBC patients treated with NAC.
    VL  - 9
    IS  - 5
    ER  - 

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Author Information
  • Department of Obstetrics and Gynecology, Universitary Hospital Quironsalud Madrid, Madrid, Spain

  • Department of Medical Oncology, Universitary Hospital Quironsalud Madrid, Madrid, Spain

  • Department of Pathology, Universitary Hospital Quironsalud Madrid, Madrid, Spain

  • Department of Obstetrics and Gynecology, Universitary Hospital Quironsalud Madrid, Madrid, Spain

  • Department of Medical Oncology, Universitary Hospital Quironsalud Madrid, Madrid, Spain

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