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The combination of Ki67, histological grade and estrogen receptor status identifies a low-risk group among 1,854 chemo-naïve women with N0/N1 primary breast cancer
Lund University, Skåne University Hospital, Lund, Sweden.
Odense University Hospital, Denmark.
Lund University, Skåne University Hospital, Lund, Sweden.
Unilabs, Mammography, Helsingborg, Sweden.
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2013 (English)In: SpringerPlus, E-ISSN 2193-1801, Vol. 2, no 111Article in journal (Refereed) Published
Abstract [en]


The aim was to confirm a previously defined prognostic index, combining a proliferation marker, histological grade, and estrogen receptor (ER) in different subsets of primary N0/N1 chemo-naïve breast cancer patients.


In the present study, including 1,854 patients, Ki67 was used in the index (KiGE), since it is the generally accepted proliferation marker in clinical routine. The low KiGE-group was defined as histological grade 1 patients and grade 2 patients which were ER-positive and had low Ki67 expression. All other patients made up the high KiGE-group. The KiGE-index separated patients into two groups with different prognosis. In multivariate analysis, KiGE was significantly associated with disease-free survival, when adjusted for age at diagnosis, tumor size and adjuvant endocrine treatment (hazard ratio: 3.5, 95% confidence interval: 2.6-4.7, P<0.0001).


We have confirmed a prognostic index based on a proliferation marker (Ki67), histological grade, and ER for identification of a low-risk group of patients with N0/N1 primary breast cancer. For this low-risk group constituting 57% of the patients, with a five-year distant disease-free survival of 92%, adjuvant chemotherapy will have limited effect and may be avoided.

Place, publisher, year, edition, pages
Springer, 2013. Vol. 2, no 111
Keyword [en]
Breast cancer; Chemo-naïve; Ki67; Prognostic index; Proliferation
National Category
Basic Medicine Clinical Medicine
URN: urn:nbn:se:liu:diva-109504DOI: 10.1186/2193-1801-2-111PubMedID: 23560250OAI: diva2:739311
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2014-11-24Bibliographically approved

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Olsson, HansStål, Olle
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Molecular and Immunological PathologyFaculty of Health SciencesDepartment of Clinical Pathology and Clinical GeneticsOncologyDepartment of Oncology
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