Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis

Breast Cancer Res. 2011 Mar 2;13(2):R22. doi: 10.1186/bcr2834.


Introduction: Triple negative breast cancer (TNBC) has a poorer survival, despite a higher response rate to neoadjuvant chemotherapy. The purpose of this study was to identify the predictive or prognostic value of Ki-67 among patients with TNBC treated with neoadjuvant chemotherapy, and the role of Ki-67 in further classification of TNBC.

Methods: A total of 105 TNBC patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were included in the present study. Pathologic complete response (pCR) rate, relapse-free survival (RFS), and overall survival (OS) were compared according to the level of Ki-67.

Results: pCR was observed in 13.3% of patients. TNBC with high Ki-67 expression (≥ 10%) showed a higher pCR rate to neoadjuvant chemotherapy than TNBC with low Ki-67 expression. None of the low Ki-67 group achieved pCR (18.2% in the high Ki-67 group vs. 0.0% in the low Ki-67 group, P = 0.019). However, a high Ki-67 expression was significantly associated with poor RFS and OS in TNBC, despite a higher pCR rate (P = 0.005, P = 0.019, respectively). In multivariate analysis, high Ki-67 was an independent prognostic factor for RFS in TNBC (hazard ratio = 7.82, P = 0.002). The high Ki-67 group showed a similar pattern of recurrence with overall TNBC, whereas the low Ki-67 group demonstrated a relatively constant hazard rate for relapse.

Conclusions: TNBC with high Ki-67 was associated with a more aggressive clinical feature despite a higher pCR rate. High proliferation index Ki-67 can be used for further classification of TNBC into two subtypes with different responses and prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis*
  • Breast Neoplasms / classification*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Disease-Free Survival
  • Docetaxel
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Female
  • Humans
  • Ki-67 Antigen / analysis*
  • Middle Aged
  • Neoadjuvant Therapy
  • Prognosis
  • Receptor, ErbB-2 / biosynthesis
  • Receptor, ErbB-2 / deficiency
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / biosynthesis
  • Receptors, Progesterone / deficiency
  • Taxoids / administration & dosage
  • Taxoids / therapeutic use
  • Tumor Suppressor Protein p53 / analysis


  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Ki-67 Antigen
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Taxoids
  • Tumor Suppressor Protein p53
  • Docetaxel
  • Doxorubicin
  • ERBB2 protein, human
  • Receptor, ErbB-2