Assessment of Ki67 in Breast Cancer: Updated Recommendations From the International Ki67 in Breast Cancer Working Group
By Torsten O. Nielsen, S. Leung, David L. Rimm, A. Dodson, Balasz Acs, S. Badve, Carsten Denkert, M. Ellis, S. Fineberg, M. Flowers and 12 more. Journal of the National Cancer Institute, 2020
663 citations recorded by the source corpus.
Abstract Ki67 immunohistochemistry (IHC), commonly used as a proliferation marker in breast cancer, has limited value for treatment decisions due to questionable analytical validity. The International Ki67 in Breast Cancer Working Group (IKWG) consensus meeting, held in October 2019, assessed the current evidence for Ki67 IHC analytical validity and clinical utility in breast cancer, including the series of scoring studies the IKWG conducted on centrally stained tissues. Consensus observations and recommendations are: 1) as for estrogen receptor and HER2 testing, preanalytical handling considerations are critical; 2) a standardized visual scoring method has been established and is recommended for adoption; 3) participation in and evaluation of quality assurance and quality control programs is recommended to maintain analytical validity; and 4) the IKWG accepted that Ki67 IHC as a prognostic marker in breast cancer has clinical validity but concluded that clinical utility is evident only for prognosis estimation in anatomically favorable estrogen receptor–positive and HER2-negative patients to identify those who do not need adjuvant chemotherapy. In this T1-2, N0-1 patient group, the IKWG consensus is that Ki67 5% or less, or 30% or more, can be used to estimate prognosis. In conclusion, analytical validity of Ki67 IHC can be reached with careful attention to preanalytical issues and calibrated standardized visual scoring. Currently, clinical utility of Ki67 IHC in breast cancer care remains limited to prognosis assessment in stage I or II breast cancer. Further development of automated scoring might help to overcome some current limitations.
Subfields: Cancer Research, Pathology and Forensic Medicine
View Paper: https://www.semanticscholar.org/paper/b1d49951301de870feeb1d3d3d61b87192d157af
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Citations in the corpus
- Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021 (2021, methodology): “The Panel generally supported recent working group recommendations that tumors with Ki67 5% do not receive chemotherapy, whereas tumors with Ki67 30% receive chemotherapy.(12) Most early-stage, ER-positive tumors, however, fall between these extremes.”