Risk with lower oncotype but high ki-67

Waves2Stars

I’m 47 any my oncotype is 14. Oncologist says this is great and means I don’t need chemo, lower risk of recurrence. I didn’t see the Ki-67 score of 40% until I got home. That’s kind of got me freaked out because it seems high. She’s the one with the degree, experience, and participates in research, so I guess I need to trust her. But I don’t know if the oncotype kind of negates the ki-67 or what

Beesie

The Oncotype score incorporates Ki-67. So it appears that your cancer cells includes some positive factors that are outweighing the Ki-67.

This is the Oncotype formula:

kksmom3

Waves2Stars, I had almost the same thing. My tumor was 3.2 mm. Too small to send out to Oncotype, or at least I presume, since they never mentioned anything about it, and they never brought up chemo and said emphatically no, about that. I know they do the Oncotype too, as I am in an in-person support group thru the hospital. But anyway, my Ki-67 was 37.5%. I was freaked as well, so I asked my MO. She wasn't at all worried about it as my mitotic score was 1. She didn't really offer an explanation for it. I was grade 2. I am nearly 3 years out, I get my mammogram this week. I read somewhere that healing biopsy tissue shows a higher proliferation rate.That does make sense, although I cannot find that info now. A lot of hospitals don't even test for it, as it can be unreliable. I wish I didn't even know, but it was on my path report. The rest of my stats are good, as are yours, so like all of us, all we can do is hope and pray for the best.

Gryffinmom

Waves2Stars,

My Ki-67 from my biopsy was a whopping 52%(Fortunately, I didn’t realize at the time what that meant) but my mitotic score was 1. My oncotype score was 8. After surgery I was grade 1 (biopsy was grade 2.) It’s been almost 4 years since my surgery and so far, so good. I check in here occasionally but, honestly, I don’t even think about it much anymore. I agree with kksmom3- just hope and pray for the best and enjoy life

Waves2Stars

Thank you all!!! It’s a challenge to get even an adequate amount of information in order to make the best decisions for myself! It’s a tremendous relief to get answers from real people who’ve been there

Salamandra

FWIW, I never got a ki-67 score. My oncologist said that it's not always reported. I was treated at well reputed cancer center and my oncologist never wanted or needed it. We followed my oncotype to decide about chemo.

Rah2464

I never received a ki-67 score either. Always wondered about that.

Waves2Stars

Also, is FISH kind of the same thing? Like being HER2 equivocal, but then negative because of FISH means really negative

ctmbsikia

So how do they calculate the oncotype score without a Ki-67? I don't have one either.

MarvieS

I'm new to this and don't know much but my BS also said that at my cancer center they do not test for Ki-67. From Beesie's posting I would understand that once they do the Oncotype score testing it includes Ki-67 testing. Maybe on the sample that is being sent in?

Beesie

Genomic Health, the Oncotype company, do all their own testing for the 21 variables they assess. They do not use the ER, PR, HER2 or Ki-67 ( if done) result from the pathology report. For ER and PR ( and maybe others, I don't know) they even use a different testing method. This is why ER and PR are sometimes different on the Oncotype report than on the pathology report.

ctmbsikia

As always, thanks Beesie.

pattik

My Ki-67 from my biopsy was also 40. I did ask for (and received) my single-gene scores from Oncotype because I wanted to see how my biopsy Ki-67 compared to their Ki-67. It was something like 5.4, so definitely a different scoring / grading system which made it impossible to compare. I also had a very strong ER / PR score from the biopsy (100%) but that was much weaker on the Oncotype. This goes inline with what Bessie said above about the difference in testing methods. My MO told me the same when I asked.

Waves2Stars

I asked my RO about ki-67. He said at Northwestern, they found the rate corresponded closely with Oncotype score. But since working in a new region, the ki has been repeatedly a lot higher than Oncotype. He’s going to do some digging to find out if it’s testing method or the way it’s read in different regions. But he said Oncotype trumps ki-67 in any treatment decision.

Awakened2021

This is exactly what's happening to me too! My Ki67 from the pathology report is 95!! It caused me so much anxiety and misery while I was waiting for my Oncotype and I was convinced that I would get a high score because of it. Turned out my score was 14 - just got the report yesterday and needless to say I was so relieved! My experience is very recent so I can't add to any long term perspective but my gut feeling is that, for whatever reason, the Ki67 might not be the most accurate, especially considering my mitosis score is only 1 (less than 1 per high power field).

Just for information, my ER turned out to be about 80% and PR is 100%, tumour is Grade 2.

Springdaisy

hello, I do not know much about KI67. Mine is low whatever that means. I would check with my doctor first but I’m wondering if anybody knows anything about KI67 like take a vitamin supplement? Thank you for your time.