Risk factors associated with discordant Ki-67 levels between preoperative biopsy and postoperative surgical specimens in breast cancers

Hyung Sun Kim, Seho Park, JaSeung Koo, Sanghwa Kim, Jee Ye Kim, Sanggeun Nam, Hyung Seok Park, Seung Il Kim, Byeongwoo Park

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose The Ki-67 labelling index is significant for the management of breast cancer. However, the concordance of Ki-67 expression between preoperative biopsy and postoperative surgical specimens has not been well evaluated. This study aimed to find the correlation in Ki-67 expression between biopsy and surgical specimens and to determine the clinicopathological risk factors associated with discordant values. Patients and Methods Ki-67 levels were immunohistochemically measured using paired biopsy and surgical specimens in 310 breast cancer patients between 2008 and 2013. ÄKi-67 was calculated by postoperative Ki-67 minus preoperative levels. The outliers of ÄKi-67 were defined as [lower quartile of ÄKi-67-1.5 ? interquartile range (IQR)] or (upper quartile + 1.5 ? IQR) and were evaluated according to clinicopathological parameters by logistic regression analysis. Results The median preoperative and postoperative Ki-67 levels were 10 (IQR, 15) and 10 (IQR, 25), respectively. Correlation of Ki-67 levels between the two specimens indicated a moderately positive relationship (coefficient = 0.676). Of 310 patients, 44 (14.2%) showed outliers of ÄKi-67 (range, -20 or 28). A significant association with poor prognostic factors was found among these patients. Multivariate analysis determined that significant risk factors for outliers of ÄKi-67 were tumor size >1 cm, negative progesterone receptor (PR) expression, grade III cancer, and age 35 years. Among 171 patients with luminal human epidermal growth factor receptor 2-negative tumors, breast cancer subtype according to preoperative or postoperative Ki-67 levels discordantly changed in 46 (26.9%) patients and a significant proportion of patients with discordant cases had 1 risk factor. Conclusion Ki-67 expression showed a substantial concordance between biopsy and surgical specimens. Extremely discordant Ki-67 levels may be associated with aggressive tumor biology. In patients with luminal subtype disease, clinical application of Ki-67 values should be cautious considering types of specimens and clinicopathological risk factors.

Original languageEnglish
Article numbere0151054
JournalPloS one
Volume11
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

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Biopsy
breast neoplasms
biopsy
risk factors
Breast Neoplasms
Tumors
neoplasms
Progesterone Receptors
Regression analysis
Labeling
Logistics
Neoplasms
type collections
multivariate analysis
regression analysis
Multivariate Analysis
Logistic Models
Regression Analysis
Biological Sciences

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Kim, Hyung Sun ; Park, Seho ; Koo, JaSeung ; Kim, Sanghwa ; Kim, Jee Ye ; Nam, Sanggeun ; Park, Hyung Seok ; Kim, Seung Il ; Park, Byeongwoo. / Risk factors associated with discordant Ki-67 levels between preoperative biopsy and postoperative surgical specimens in breast cancers. In: PloS one. 2016 ; Vol. 11, No. 3.
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title = "Risk factors associated with discordant Ki-67 levels between preoperative biopsy and postoperative surgical specimens in breast cancers",
abstract = "Purpose The Ki-67 labelling index is significant for the management of breast cancer. However, the concordance of Ki-67 expression between preoperative biopsy and postoperative surgical specimens has not been well evaluated. This study aimed to find the correlation in Ki-67 expression between biopsy and surgical specimens and to determine the clinicopathological risk factors associated with discordant values. Patients and Methods Ki-67 levels were immunohistochemically measured using paired biopsy and surgical specimens in 310 breast cancer patients between 2008 and 2013. {\"A}Ki-67 was calculated by postoperative Ki-67 minus preoperative levels. The outliers of {\"A}Ki-67 were defined as [lower quartile of {\"A}Ki-67-1.5 ? interquartile range (IQR)] or (upper quartile + 1.5 ? IQR) and were evaluated according to clinicopathological parameters by logistic regression analysis. Results The median preoperative and postoperative Ki-67 levels were 10 (IQR, 15) and 10 (IQR, 25), respectively. Correlation of Ki-67 levels between the two specimens indicated a moderately positive relationship (coefficient = 0.676). Of 310 patients, 44 (14.2{\%}) showed outliers of {\"A}Ki-67 (range, -20 or 28). A significant association with poor prognostic factors was found among these patients. Multivariate analysis determined that significant risk factors for outliers of {\"A}Ki-67 were tumor size >1 cm, negative progesterone receptor (PR) expression, grade III cancer, and age 35 years. Among 171 patients with luminal human epidermal growth factor receptor 2-negative tumors, breast cancer subtype according to preoperative or postoperative Ki-67 levels discordantly changed in 46 (26.9{\%}) patients and a significant proportion of patients with discordant cases had 1 risk factor. Conclusion Ki-67 expression showed a substantial concordance between biopsy and surgical specimens. Extremely discordant Ki-67 levels may be associated with aggressive tumor biology. In patients with luminal subtype disease, clinical application of Ki-67 values should be cautious considering types of specimens and clinicopathological risk factors.",
author = "Kim, {Hyung Sun} and Seho Park and JaSeung Koo and Sanghwa Kim and Kim, {Jee Ye} and Sanggeun Nam and Park, {Hyung Seok} and Kim, {Seung Il} and Byeongwoo Park",
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Risk factors associated with discordant Ki-67 levels between preoperative biopsy and postoperative surgical specimens in breast cancers. / Kim, Hyung Sun; Park, Seho; Koo, JaSeung; Kim, Sanghwa; Kim, Jee Ye; Nam, Sanggeun; Park, Hyung Seok; Kim, Seung Il; Park, Byeongwoo.

In: PloS one, Vol. 11, No. 3, e0151054, 01.03.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors associated with discordant Ki-67 levels between preoperative biopsy and postoperative surgical specimens in breast cancers

AU - Kim, Hyung Sun

AU - Park, Seho

AU - Koo, JaSeung

AU - Kim, Sanghwa

AU - Kim, Jee Ye

AU - Nam, Sanggeun

AU - Park, Hyung Seok

AU - Kim, Seung Il

AU - Park, Byeongwoo

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose The Ki-67 labelling index is significant for the management of breast cancer. However, the concordance of Ki-67 expression between preoperative biopsy and postoperative surgical specimens has not been well evaluated. This study aimed to find the correlation in Ki-67 expression between biopsy and surgical specimens and to determine the clinicopathological risk factors associated with discordant values. Patients and Methods Ki-67 levels were immunohistochemically measured using paired biopsy and surgical specimens in 310 breast cancer patients between 2008 and 2013. ÄKi-67 was calculated by postoperative Ki-67 minus preoperative levels. The outliers of ÄKi-67 were defined as [lower quartile of ÄKi-67-1.5 ? interquartile range (IQR)] or (upper quartile + 1.5 ? IQR) and were evaluated according to clinicopathological parameters by logistic regression analysis. Results The median preoperative and postoperative Ki-67 levels were 10 (IQR, 15) and 10 (IQR, 25), respectively. Correlation of Ki-67 levels between the two specimens indicated a moderately positive relationship (coefficient = 0.676). Of 310 patients, 44 (14.2%) showed outliers of ÄKi-67 (range, -20 or 28). A significant association with poor prognostic factors was found among these patients. Multivariate analysis determined that significant risk factors for outliers of ÄKi-67 were tumor size >1 cm, negative progesterone receptor (PR) expression, grade III cancer, and age 35 years. Among 171 patients with luminal human epidermal growth factor receptor 2-negative tumors, breast cancer subtype according to preoperative or postoperative Ki-67 levels discordantly changed in 46 (26.9%) patients and a significant proportion of patients with discordant cases had 1 risk factor. Conclusion Ki-67 expression showed a substantial concordance between biopsy and surgical specimens. Extremely discordant Ki-67 levels may be associated with aggressive tumor biology. In patients with luminal subtype disease, clinical application of Ki-67 values should be cautious considering types of specimens and clinicopathological risk factors.

AB - Purpose The Ki-67 labelling index is significant for the management of breast cancer. However, the concordance of Ki-67 expression between preoperative biopsy and postoperative surgical specimens has not been well evaluated. This study aimed to find the correlation in Ki-67 expression between biopsy and surgical specimens and to determine the clinicopathological risk factors associated with discordant values. Patients and Methods Ki-67 levels were immunohistochemically measured using paired biopsy and surgical specimens in 310 breast cancer patients between 2008 and 2013. ÄKi-67 was calculated by postoperative Ki-67 minus preoperative levels. The outliers of ÄKi-67 were defined as [lower quartile of ÄKi-67-1.5 ? interquartile range (IQR)] or (upper quartile + 1.5 ? IQR) and were evaluated according to clinicopathological parameters by logistic regression analysis. Results The median preoperative and postoperative Ki-67 levels were 10 (IQR, 15) and 10 (IQR, 25), respectively. Correlation of Ki-67 levels between the two specimens indicated a moderately positive relationship (coefficient = 0.676). Of 310 patients, 44 (14.2%) showed outliers of ÄKi-67 (range, -20 or 28). A significant association with poor prognostic factors was found among these patients. Multivariate analysis determined that significant risk factors for outliers of ÄKi-67 were tumor size >1 cm, negative progesterone receptor (PR) expression, grade III cancer, and age 35 years. Among 171 patients with luminal human epidermal growth factor receptor 2-negative tumors, breast cancer subtype according to preoperative or postoperative Ki-67 levels discordantly changed in 46 (26.9%) patients and a significant proportion of patients with discordant cases had 1 risk factor. Conclusion Ki-67 expression showed a substantial concordance between biopsy and surgical specimens. Extremely discordant Ki-67 levels may be associated with aggressive tumor biology. In patients with luminal subtype disease, clinical application of Ki-67 values should be cautious considering types of specimens and clinicopathological risk factors.

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