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The Value of Ki67 in Very Young Women with Hormone Receptor-Positive Breast Cancer: Retrospective Analysis of 9,321 Korean Women

Annals of Surgical Oncology volume 22, pages 3481–3488 (2015)Cite this article

Abstract

Background

Young breast cancer patients have a poorer prognosis, especially when their tumors are hormone receptor positive. We analyzed the association between Ki67 and age and the impact of these factors on outcomes in hormone receptor-positive breast cancer.

Methods

The records of 9,321 hormone receptor-positive invasive breast cancer patients from three large centers were retrospectively reviewed. Each institution separately assayed Ki67 level immunohistochemically. Univariate and multivariate analysis for recurrence-free survival (RFS) was performed on 4,738 patients from a single center.

Results

Ki67 level was inversely proportional to age in all three data sets and was significantly higher for younger patients (p < 0.001, 0.03, and <0.001, respectively). This correlation was seen only in the human epidermal growth factor receptor 2 (HER2)-negative population. Survival analysis showed that both very young age (<35 years) and high Ki67 level (≥10 %) were independent prognostic factors. Although young age was a worse prognostic indicator regardless of HER2 status, Ki67 index was associated with worse prognosis only in HER2-negative patients. When patients were stratified into those with low and high Ki67, young age remained a significant factor for RFS, with hazard ratios in these two Ki67 groups of 2.15 and 2.57, respectively (p < 0.001). Also, the young age/low Ki67 group had significantly poorer RFS than the older age/high Ki67 group (p < 0.001).

Conclusions

Ki67 level was higher in younger patients. However, very young patients had a poorer prognosis regardless of Ki67 level. Unknown biologic factors other than high cell proliferation might play a role in the aggressiveness of hormone receptor-positive breast cancer in very young patients.

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Acknowledgment

Supported in part by a National Research Foundation of Korea (NRF) Grant funded by the Korea government (MSIP) (Grant 2012M3A9B2028834) and the SNUH Research Fund (Grant 04-2010-1150).

Disclosure

The authors declare no conflict of interest.

Author information

Affiliations

  1. Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea

    Jisun Kim MD & Tae Kyung You MD

  2. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Wonshik Han MD, PhD, Hyeong-Gon Moon MD, PhD, Min Kyoon Kim MD, PhD, Jong Jin Kim MD, Eun Shin Lee MD, In Ae Park MD, PhD & Dong-Young Noh MD, PhD

  3. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Korea

    So-Youn Jung MD, Han-Sung Kang MD, PhD, Eun Sook Lee MD, PhD & Jungsil Ro MD, PhD

  4. Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Yeon Hee Park MD, PhD, Jeong Eon Lee MD, PhD, Seok Jin Nam MD, PhD & Young-Hyuck Yim MD, PhD

  5. Momm’s Clinic, Seoul, Korea

    Soo Kyung Ahn MD

  6. Department of Surgery, Iwha University College of Medicine, Seoul, Korea

    Jun Woo Lee MD

Authors
  1. Jisun Kim MD
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  2. Wonshik Han MD, PhD
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  3. So-Youn Jung MD
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  4. Yeon Hee Park MD, PhD
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  5. Hyeong-Gon Moon MD, PhD
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  7. Jun Woo Lee MD
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  8. Min Kyoon Kim MD, PhD
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  9. Jong Jin Kim MD
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  10. Eun Shin Lee MD
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  11. Tae Kyung You MD
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  12. Han-Sung Kang MD, PhD
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  13. Eun Sook Lee MD, PhD
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  14. Jungsil Ro MD, PhD
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  15. Jeong Eon Lee MD, PhD
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  16. Seok Jin Nam MD, PhD
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  17. Young-Hyuck Yim MD, PhD
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  18. In Ae Park MD, PhD
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  19. Dong-Young Noh MD, PhD
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Corresponding author

Correspondence to Wonshik Han MD, PhD.

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Kim, J., Han, W., Jung, SY. et al. The Value of Ki67 in Very Young Women with Hormone Receptor-Positive Breast Cancer: Retrospective Analysis of 9,321 Korean Women. Ann Surg Oncol 22, 3481–3488 (2015). https://doi.org/10.1245/s10434-015-4399-1

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  • DOI: https://doi.org/10.1245/s10434-015-4399-1

Keywords

  • Breast Cancer
  • Ki67 Index
  • Ki67 Level
  • Young Breast Cancer Patient
  • National Cancer Center