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Ki-67

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buffalo3 View Drop Down
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    Posted: Sep 02 2014 at 11:10pm
Hi Good People on this Forum:

Has anyone on this forum had a Ki-67 of 100%...the most cell proliferation possible and if so, what is your experience, if you are willing to share, with surgery, and treatment.  The tumor my niece has is 4.5 cm and 100% in terms of Ki-67.
Thanks for any discussion or sharing possible.
I'm up late a worried.
Sharbuffalo
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 7:51am
Shar,

Most TNBC have a high KI-67 score and why we are most always Grade 3 when diagnosed.  You'll see many who's scores are in the 90's or even 100%.  For what it's worth, mine was 48%, but I still had a recurrence.  I think the actual number and what the prognostic value means are still controversial.  We just know TNBC usually presents with a higher score meaning it's fast growing and more aggressive than other types of breast cancer.

This is from Breastcancer.org
 
Your pathology report may include information about the rate of cell growth — what proportion of the cancer cells within the tumor are growing and dividing to form new cancer cells. A higher percentage suggests a faster-growing, more aggressive cancer, rather than a slower, “laid back” one. 

Ki-67 is a protein in cells that increases as they prepare to divide into new cells. A staining process can measure the percentage of tumor cells that are positive for Ki-67. The more positive cells there are, the more quickly they are dividing and forming new cells. In breast cancer, a result of less than 10% is considered low, 10-20% borderline, and high if more than 20%.
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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buffalo3 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 8:00am
Hu Donna
This matches the research I've done. What I was hoping to hear I gave me. I wondered about experience of members and their numbers and results which u offered. Thank you so much!
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 8:46am
I think being Grade 3, having a higher KI67 also means it should respond to chemo since chemo goes after fast dividing cells.  Trying to look at the bright side!  I thought having a lower KI67 of 48 was a good thing, but I still had a recurrence.  On the other hand, I've seen other women in this group with high KI67's and never recur.  
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Genie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Genie Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 10:54am
Shar, I am 6 years out. My KI-67 was 87% at biopsy and by the time I had my bi-mx just 3 weeks later, the KI-67 was 99%. I tend to believe that chemo is more effective on those tumors with the higher KI-67 scores.
DX 3/10/08 at age 67, IDC. Stage 1, Grade 3, 1.5 cm.
KI-67 99% at MX . Bilateral mastectomy 4/1/08 Node-, BRCA 1/2-,BARD1+, TX:Cytoxan/Taxotere x4,3 in family with TNBC
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buffalo3 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 10:59am
That's encouraging.  It seems we have to look at both the bright and darker sides to get a balanced way to wield the many intuitions and emotions...!  Thank you.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 11:40am
Thank you Genie!!  It's very helpful to know that someone here had such a high Ki-67 and is here to write about it!  Grateful to you and glad you are here. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TriplePositiveGirl Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 11:50am
Hi Shar,

I'm sorry your niece is dealing with this and that you are worried. I thought I would mention that my Ki67 score was measured at 50% to during the biopsy stage. I had neo-adjuvent chemo prior to surgery in order to shrink the tumor (I had opted for a lumpectomy and needed to have a good result from the chemo in order to do this). When the tumor was removed, the Ki67 score AFTER chemo was around 12%, which tells me the chemo was working to slow down the dividing cells. I've also read that the Ki67 score does not necessarily have any baring on survival rates or outcomes so I would not focus a lot of energy worrying about this issue. An aggressive cancer is an aggressive cancer regardless of the score and needs to be treated aggressively. 
I am sending positive thoughts to you and your niece!
Lisa
Diagnosed Jan 2010; Stage IIa, grade 2, 3.2cm in rt. breast, no nodes and BRCA-. 4 cycles Carbo/Gemzar 3/10; Lump 6/10; 2 cycles carbo/gem after surgery 8/10; 35 Rads finished 12/1/10. NED.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 3:22pm
Hi Lisa,
Your story is encouraging in that your tumor size is nearer my niece's.  I am very happy you have had good success!!!  Thank you for sharing.  All these little stories and stats help me because when I feel educated and have a broader range of experiences I can settle easier.  I so appreciate your sharing. Sharon
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mindy555 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 7:04pm
Hi shar,

What a loving wonderful aunt you are.  I agree with TriplePositiveGirl.  It really has no bearing on the outcome.  As Donna explained it's a gauge on how rapidly the cells are dividing.  Mine was either 98 or 99%.  I'd have to pull out my initial path report.  I too had chemo before mastectomy and they found a dead tumor bed without a trace of carcinoma- so the chemo did its job well.  I wish the same for your dear niece. 

Take care- I know about those sleepless nights.  I'm 100% sure we all do!

Mindy 
Dx July 2011 56 yo
Stage I IDC,TN,Grade 3
Grew to Stage IIa- No ev of node involve- BRCA1+ chondroid metaplasia
Daughter also BRCA1+
Mass grew on Taxol
FEC 6x better
BMX 3/19/12 pCR NED
BSO 6/2012
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buffalo3 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 10:46pm
Hi Mindy,
Thank you so much for writing in and sharing about your Ki-67 status at time of diagnosis.  Boy, you AND your daughter with BRCA1...that is really hard...I know it goes that way but still,  HARD.  That's remarkable that your tumor was so zapped by the chemo.  Amazing.  I have been reading about that response.  My niece is going to have surgery first and soon...for reasons related to fertility.  She definitely wants the option to have a child down the road and so that is a big priority for her.  So much to think about in regard to the order of the treatment.  I think seeing her Ki-67 at 100% and the surgery first, I was concerned.  There are many pathways it seems! 

I did find a research article on Ki-67 that is very interesting.  It was published in 2011 in Breast Cancer Research.  If anyone wants the link message me and I will send it. 

Thanks again for sharing your personal story on the proliferation rate of your tumor!

Best,
Sharbuffalo3



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Post Options Post Options   Thanks (0) Thanks(0)   Quote trishiecat Quote  Post ReplyReply Direct Link To This Post Posted: Sep 03 2014 at 11:56pm
hi shar,

Not sure this will help you in any way but I am 10 years out: grade 3, 5 cm tumor, no nodes, not sure about ki-67. No recurrence.

I was dx by my internal med dr. he told me I had the good kind of cancer?? I had a bmx done by a general surgeon, so mine was really fly by the seat of your pants. I found the mass on jan. 31 and had surgery by feb. 11. No one even knew we had an oncologist in town! I had the basic chemo for that time, devil's kool-aid, ACT. 

I just wanted to let you know that there are old timers out here, most probably no longer come to the site.

hang in there,
trishiecat
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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 04 2014 at 11:02am
Trisha,
You made my day!  YES, it helps to hear your story.  Your tumor was bigger than my niece's and so far there are no + nodes or MRI.  thank you so much for sharing!!!  Really, sometimes the emotional and spiritual boost that comes through a survivor is KEY to keeping the center both hopeful and strong.  Thank you.  So happy to hear from you and know you are still here 10 years later.  Wow!  Sharbuffalo3
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Post Options Post Options   Thanks (0) Thanks(0)   Quote buffalo3 Quote  Post ReplyReply Direct Link To This Post Posted: Sep 21 2014 at 10:55am
Thank you all for the responses regarding Ki-67 scores!  I took them all in and am choosing now to believe that the high score could mean something positive!  I am going there.  Thanks ALL of you.  I was so busy with hospitals and treatment plan when I asked the question (for my niece) that I am just not getting back with you all.  BUT, what you wrote HELPED. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Apr 08 2016 at 5:08pm

New predictive tool for assessing breast cancer risk

Levels of molecular marker Ki67 in healthy breast tissue predicts a woman's risk of developing breast cancer.

Harvard Stem Cell Institute (HSCI) researchers at Dana-Farber Cancer Institute (DFCI) and collaborators at Brigham and Women's Hospital (BWH) have identified a molecular marker in normal breast tissue that can predict a woman's risk for developing breast cancer, the leading cause of death in women with cancer worldwide.

The work, led by HSCI principal faculty member Kornelia Polyak and Rulla Tamimi of BWH, was published in an early online release and in the April 1 issue of Cancer Research.

The study builds on Polyak's earlier research finding1 that women already identified as having a high risk of developing cancer -- namely those with a mutation called BRCA1 or BRCA2 -- or women who did not give birth before their 30s had a higher number of mammary gland progenitor cells.

In the latest study, Polyak, Tamimi, and their colleagues examined biopsies, some taken as many as four decades ago, from 302 participants in the Nurses' Health Study and the Nurses' Health Study II who had been diagnosed with benign breast disease. The researchers compared tissue from the 69 women who later developed cancer to the tissue from the 233 women who did not. They found that women were five times as likely to develop cancer if they had a higher percentage of Ki67, a molecular marker that identifies proliferating cells, in the cells that line the mammary ducts and milk-producing lobules. These cells, called the mammary epithelium, undergo drastic changes throughout a woman's life, and the majority of breast cancers originate in these tissues.

Doctors already test breast tumors for Ki67 levels, which can inform decisions about treatment, but this is the first time scientists have been able to link Ki67 to precancerous tissue and use it as a predictive tool.

"Instead of only telling women that they don't have cancer, we could test the biopsies and tell women if they were at high risk or low risk for developing breast cancer in the future," said Polyak, a breast cancer researcher at Dana-Farber and co-senior author of the paper.

"Currently, we are not able to do a very good job at distinguishing women at high and low risk of breast cancer," added co-senior author Tamimi, an associate professor at the Harvard T.H. Chan School of Public Health and Harvard Medical School. "By identifying women at high risk of breast cancer, we can better develop individualized screening and also target risk reducing strategies."

To date, mammograms are the best tool for the early detection, but there are risks associated with screening. False positive and negative results and over-diagnosis could cause psychological distress, delay treatment, or lead to overtreatment, according to the National Cancer Institute (NCI).

Mammography machines also use low doses of radiation. While a single mammogram is unlikely to cause harm, repeated screening can potentially cause cancer, though the NCI writes that the benefits "nearly always outweigh the risks."

"If we can minimize unnecessary radiation for women at low risk, that would be good," said Tamimi.

Screening for Ki67 levels would "be easy to apply in the current setting," said Polyak, though the researchers first want to reproduce the results in an independent cohort of women.

http://www.medicalnewstoday.com/releases/308841.php



Edited by 123Donna - Apr 08 2016 at 5:09pm
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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