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Background: Ki-67 overexpression has been reported to be related to a poor prognosis for early stage breast cancer. We analyzed whether Ki-67 has a prognostic impact on risk subgroups based on the recommendations at St. Gallen in 2007. Methods: To determine the impact of Ki-67 on each risk group, a retrospective analysis was performed in patients with breast cancer who underwent curative surgery. Ki-67 was examined by immunohistochemistry with a predefined cutoff level of 10%. Results: A total of 1,166 patients were eligible for this analysis. During the follow-up period, distant metastasis was observed in 164 patients (14.1%), and 80 patients (6.9%) died. Ki-67 overexpression (Ki-67 ≥10%) was identified as an independent prognostic factor for distant-metastatic-free survival (DFS) and overall survival (OS) by univariate and multivariate analysis. In the intermediate-risk group, the difference between Ki-67 overexpression and no overexpression was statistically significant in 5-year DFS (90.9 vs. 83.4%, p = 0.002) and OS (98.1 vs. 95.8%, p = 0.002). However, in both the low- and high-risk groups, Ki-67 overexpression was not an independent prognostic factor for either 5-year DFS or OS. Conclusions: Ki-67 overexpression indicates an unfavorable prognostic impact for DFS and OS. However, this impact is restricted only to those patients classified at intermediate risk. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

While pertuzumab was added to adjuvant therapy for high-risk HER2-positive breast cancer according to APHINY trial, definition of "high risk of recurrence" is still unclear. Because neoadjuvant chemotherapy (NAC) including anti-HER2 drugs showed potent efficacy to achieve pCR and better survival, one lymph node metastases may show survival outcomes equivalent to node-negative cases. Hence, we examined the risk factors of recurrence in HER2-positive breast cancer and determined whether one lymph node metastasis after NAC is true predictor of recurrence. From May 1993 to March 2017, patients who underwent radical mastectomy/partial mastectomy after NAC for breast cancer in our institution were retrospectively examined. Among those patients, HER2-positive patients were 253, 23% of all patients. Breast cancer recurrence occurred in 46 (18.2%) of HER2-positive patients who underwent NAC and radical mastectomy. Multivariate analysis was performed on tumor size, lymph node metastasis, hormone receptor, Ki-67, preoperative chemotherapy regimen for recurrence risk factor. The risk of recurrence was significantly higher in one lymph node metastasis group than in the node-negative group (HR 6.157, p=.0006, 95%CI 2.175-17.435). Likewise, the risk of recurrence was significantly higher in the group with two or more lymph node metastases than in the node-negative group (HR 3.877, p=.0107, 95%CI 1.370-10.972). The presence of even one lymph node metastasis was suggested as a risk factor of recurrence, likely representing metastatic potential of the disease. [ABSTRACT FROM AUTHOR]

While pertuzumab was added to adjuvant therapy for high-risk HER2-positive breast cancer according to APHINY trial, definition of "high risk of recurrence" is still unclear. Because neoadjuvant chemotherapy (NAC) including anti-HER2 drugs showed potent efficacy to achieve pCR and better survival, one lymph node metastases may show survival outcomes equivalent to node-negative cases. Hence, we examined the risk factors of recurrence in HER2-positive breast cancer and determined whether one lymph node metastasis after NAC is true predictor of recurrence. From May 1993 to March 2017, patients who underwent radical mastectomy/partial mastectomy after NAC for breast cancer in our institution were retrospectively examined. Among those patients, HER2-positive patients were 253, 23% of all patients. Breast cancer recurrence occurred in 46 (18.2%) of HER2-positive patients who underwent NAC and radical mastectomy. Multivariate analysis was performed on tumor size, lymph node metastasis, hormone receptor, Ki-67, preoperative chemotherapy regimen for recurrence risk factor. The risk of recurrence was significantly higher in one lymph node metastasis group than in the node-negative group (HR 6.157, p=.0006, 95%CI 2.175-17.435). Likewise, the risk of recurrence was significantly higher in the group with two or more lymph node metastases than in the node-negative group (HR 3.877, p=.0107, 95%CI 1.370-10.972). The presence of even one lymph node metastasis was suggested as a risk factor of recurrence, likely representing metastatic potential of the disease. [ABSTRACT FROM AUTHOR]