The association between Ki-67 expression and survival in breast cancer subtypes: a cross-sectional study of Ki-67 cut-point in northern Thailand

Bibliographic Details
Title: The association between Ki-67 expression and survival in breast cancer subtypes: a cross-sectional study of Ki-67 cut-point in northern Thailand
Authors: Phanchaporn Wongmaneerung, Imjai Chitapanarux, Patrinee Traisathit, Sukon Prasitwattanaseree, Wisanu Rottuntikarn, Areewan Somwangprasert, Chagkrit Ditsatham, Kirati Watcharachan, Pitchayaponne Klunklin, Wimrak Onchan
Source: BMC Cancer, Vol 25, Iss 1, Pp 1-11 (2025)
Publisher Information: BMC, 2025.
Publication Year: 2025
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: Breast cancer, Ki-67, Cut-off, Subtype, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: Abstract Background Breast cancer is a major health concern worldwide, and Ki-67 level index is a prognostic factor that indicates tumor proliferation and predicts survival outcomes. However, the standard Ki 67 cut-off level varies between local laboratories, and in Thailand, there is no established optimal cut-off level. Objective This study aimed to determine the optimal cut-off point for Ki-67 expression and investigate the association between Ki-67 levels and other prognostic factors with 8-year overall survival. Method A retrospective review of Ki-67 levels was conducted in non-metastatic breast cancer patients treated at Maharaj Nakorn Chiangmai hospital from January 2013-December 2015, including 507 breast cancer patients. Results The ROC curve analysis identified the optimal Ki-67 cut-point as ≥ 30%, with 75% sensitivity and 48.85% specificity. Age over 60 was associated with higher mortality regardless of cancer stage. Locally advanced staging, nodal involvement, Ki-67 ≥ 30%, and triple-negative subtype correlated with poorer survival. Even after adjustments, these factors remained significant in prognostic evaluation. Chemotherapy notably improved survival, especially in high Ki-67 (≥ 30) patients. However, this effect was not seen in low Ki-67 patients. High Ki-67 patients receiving chemotherapy showed improved survival in early-stage, node-negative cases compared to those who did not receive chemotherapy. HER2-positive patients with high Ki-67 benefited from chemotherapy, but statistical significance was not reached in hormone-positive patients. Conclusion This study identified the optimal cut point for Ki-67 in Northern Thailand as 30%. Patients with KI-67 above 30% show significantly lower 8-year survival rates. This is especially relevant for low-risk patients, like those with hormonal subtypes or early-stage nodal negativity. In these cases, KI-67 becomes crucial for treatment decisions. Our study not only aids Northern Thailand’s understanding but also aligns with broader research, emphasizing KI-67’s vital role in planning treatment for low-risk breast cancer patients.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2407
Relation: https://doaj.org/toc/1471-2407
DOI: 10.1186/s12885-025-13724-w
Access URL: https://doaj.org/article/1eca2bbb70b34758a33e16efd94f6d5d
Accession Number: edsdoj.1eca2bbb70b34758a33e16efd94f6d5d
Database: Directory of Open Access Journals
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More Details
ISSN:14712407
DOI:10.1186/s12885-025-13724-w
Published in:BMC Cancer
Language:English