Ki67

Hi Nachout818 -

While you wait for the ever-helpful response of our wonderful members, here you may want to check out the main Breastcancer.org site's page on Rate of Cell Growth, which explains why the Ki67 test is used and how it's interpreted and weighed by doctors.

We hope this helps!

--The Mods

Hello. I was dx in June 2014 with 3 IDC tumors. The larger 2 biopsy results came back 81% and 87%! Crazy high!!! I, of course, freaked out. My doc is head of breast oncology at a large cancer center here and he kind of poo-pooed the ki-67. He said he would consider it in my treatment plan, along with the fact that my IDC was grade 3, but mentioned if he tested my tumor 10 times he would get different results each time. He said there is no standard for testing ki67 and many doctors and labs don't even bother reporting the number. My final pathology came back with ki67 scores of 35% and 65%. Obviously still very high...but also 30 and 50% difference from biopsy.

Your pathology results look great as far as cancer goes. I would not worry at all-out your ki67. Seems like a fluke result based on your grade 1 status.

Most of my doctors were concerned by it, while one shrugged it off. I think as an indicator of aggressiveness or response to neo-adjuvant treatment it's one more tool in the tool box, among many.

While it is variable, I've noted that there's no effort to standardize readings, thus perpetuating the issue.

New Direction - My MO believes me to be closer to luminal B than otherwise although not a classic, clear cut lum. B - my cancer had some odd characteristics. I did neo-adjuvant Femara which brought my Ki-67 down from 43% to 4% (after 5 weeks) and 1% at time of surgery. (It also shrank my tumor and nodes, although I did not achieve pCR) That was a pretty impressive demonstration, for me, of the effectiveness of an AI even on a 'less responsive' cancer.

I'm not saying that would apply to everyone, by any means, but I've found that knowledge very supportive and encouraging. I hope you are responding just as well, despite the fact that you have no way of seeing it so clearly.

Good luck to you.

I'm glad you had a strong response to neoad. chemo, New Direction, and hope the same is happening for you with your AI or tamox. I know how fortunate I am to actually know that I respond well to Femara. I wish more women had that opportunity and understood what a powerful tool AIs, etc., can be.

Kattis -it is not uncommon for Her2+ patients to have a higher ki67% as this goes hand in hand with the aggressive nature of this type. Anything above 20% is considered "high" but I think among Her2+ folks on this board, there are many with much higher numbers, myself included. Also important to note that ki67 is indicative of cell growth, which is separate from spread. There are those with large tumors that have not spread, and those with smaller tumors, which have. It is not a definitive correlation. Here is the info from BCO on ki67.

http://www.breastcancer.org/symptoms/diagnosis/rate_grade