YIKES!!! (What's up with proliferation genes)?

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weesa
weesa Member Posts: 707
edited June 2014 in Stage III Breast Cancer

The other day I responded to Ling29 in the IBC forum.  She had asked if anybody had a high proliferation gene--hers was 80%. I hauled out my pathology report which stays crumpled up in the back of my desk drawer under my computer. I was pretty sure I had a Ki-67 that was high--yep, 75%.I reassured Ling I was living proof that a high Ki-67 didn't necessarily spell doom. But then I got to wondering--my mitotic index was a "1" indicating it was dividing very slowly but my Ki-67 indicated fast growing, I think. My grade was grade 2. Anybody else have a very high Ki-67? Anybody know what it means to have a low mitotic rate and a sky high Ki-67?

I guess this topic is proof that you are never too far out to not get panicked once in a while and start obsessing about something stashed in the far back of a drawer. The collective wisdom of the BC Boards is so huge, I know somebody will come along and reassure me and Ling.

Love to all my stage 3'ers and Happy Holidays...Weesa

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  • worldwatcher
    worldwatcher Member Posts: 205
    edited December 2010

    Interesting post, Weesa...look at my signature line....very low Ki-67 and mitotic yet they graded it a 3. When I asked I was told it wasn't because of the HER2+.

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2010

    Hi Weesa,  now I'm wondering because the Ki-67 on my path report was only mentioned on the presurgical biopsy path report.  I'll have to pull it out now and look at it again, but I think it was a low percent.  Happy Holidays to you too!!

    image

    Barb

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  • paml
    paml Member Posts: 81
    edited December 2010

    Hi Weesa,

    I am glad you started this discussion. I was told I had a high proliferation rate. I think the number was 53% Whats considered high and whats considered low? They act like this is gloom and doom when I go and see them but I cant quite understand what it means. I ask my rad onc if I have such a high proliferation, then why am I a grade 2? He just looked at me and said "thats a good question? What? anyone out there know the range? Thanks

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2010

    I pulled out my pre-surgical path report from the biopsy and saw "Low Proliferation" % nuclei stained = % 8.8

    I also noticed on the next line  P53 1  "Negative"  % nuclei stained = 0.5.  I guess this is why my doctors told me my tumor was slow growing for years.  I can't understand though, why this slow growing tumor was never picked up on previous mammos and not until I found the lump myself, 4 mtns after my last mammo.  It's like nobody wants to acknowledge that other than the exuce of dense breasts.

    image

    http://www.smileycentral.com/?partner=ZSzeb001_ZNman000 Barb

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited February 2011

    delete

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  • lago
    lago Member Posts: 17,186
    edited December 2010

    My path report says: MIB-1: high proliferative index, 20%
    _____________________________

    then there is an explanation below:
    MIB-1 (Ki-67)  20%=unfavorable, 10% to 20%=intermediate ,10%=favorable

    I know I was told from the start I had a very fast growing tumor. I probably had it for only 4 years (and it was 5.5cm!)

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  • Omaz
    Omaz Member Posts: 5,497
    edited December 2010

    I think the tumor grade is a combination of three different things: tubule formation (scored 1-3) + mitotic count (scored 1-3) + nuclear pleomorphism (scored 1-3).  1 is better, 3 is worse.  The scores are apparently summed and grade 1 tumor is a sum of 3-5, grade 2 tumor is a sum of  6-7 and grade 3 tumor is a sum of  8-9. So I think the mitotic score is only part of the grade.

    NOTTINGHAM GRADING SYSTEM 

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited December 2010

    I had more info on my first pathology report, but the surgical pathology seemed general to me.  Can the ki-67, p53 and all the other original biopsy change on the surgical biopsy?

    image

    http://www.smileycentral.com/?partner=ZSzeb001_ZNman000 Barb

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  • LRM216
    LRM216 Member Posts: 2,115
    edited December 2010

    Yes, they do change in the surgical path report.  The biopsy report is just a tiny shred of the original tumor(s) - the surgical path report is what the oncs go by, as that is the testing on the complete tumor (or all that they removed).  My Ki-67 was 33% on biopsy report and on surgical report it was 61%.  I don't have anything pertaining to P-53 on either of my reports.  But I do know all pathology depts do some additional tests which others don't.  Hate that - one would think they would all have to test for all the same things.  I know some triple negs that had their cell type on their path reports, i.e., non-basal, basal, etc.  My path dept does not test for that - really stupid in my eyes.  Agree with Heidi - my onc said the same thing about the ki-67 - that it's really not that important and is only a small part of the whole pic.

    Anyhoo - I hate this freaking disease.

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  • AnacortesGirl
    AnacortesGirl Member Posts: 1,758
    edited December 2010

    Weesa -

    My path was moderate Ki-67 and grade 3.  My interpetation (back when I talked to my onc about this) was that the cells were dividing at a moderate rate but the grade 3 meant they were very irregular and more prone to invasion of other cells.  So the lump grows moderately but the dang things were trying to get involved where they shouldn't.

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