Inter-Relationship of Ki-67 and Triple-Negative Breast Cancer

Abstract

Triple-negative breast cancer (TNBC) is a heterogeneous group characterized by an early onset, aggressive course of the disease, a higher tendency of visceral metas-tases, and a poorer prognosis. It is also associated with basal-like phenotype and germline mutations for BRCA genes in 10-20% and somatic mutations in 3-5% of cases. Based on gene expression profiling, TNBC is divided into four tumor-specific subtypes (Basal-like 1, Basal-like 2, Mesenchymal, and Luminal androgen receptor) with different clinical, prognostic, and therapeutic implications. The Ki-67 antigen, a non-histone nuclear protein, is a surrogate marker to assess tumor proliferation. As TNBCs are expected to be highly proliferating tumors, a higher baseline Ki-67 level has been seen. Although a higher Ki-67 level is associated with a higher pathological complete response rate, the best cutoff point of this marker as a prognostic and predictive factor in TNBC remains unclear.