Ki 67 expression in breast carcinoma – Its relationship with age of the patients and pathological stage of the disease

Abstract

Background: Breast carcinoma is a heterogeneous tumor with different histological subtypes and classifications. The role of proliferative molecule Ki67 in breast carcinoma is both as a prognostic and theranostic marker. However it lacks analytical validity and not recommended for routine use. In the recently concluded Galen’s conference, Ki 67 cut off of 30% was recommended to determine the chemotherapy requirement. Ki 67 working group recommends 5% Ki 67 as negative and 30% Ki 67 index as significant.This study was done to analyze the ki67 expression in different age groups and different TNM stages. Materials and Methods: During our one year study period, the received breast specimen cases were analyzed by our panelists. Ki67 Immunohistochemistry was done and on which manual scoring was done. Age wise incidence of breast carcinoma, correlation between ki67 and age and relationship between ki67 and various stages were tabulated. p value was calculated to find out if there is any significance between the variants analyzed. Results: Out of 113 cases received, on ninety cases Ki67 Immunohistochemistry was done and rest was excluded. Mean age incidence was 51.8 years. High Ki 67 proliferating index was seen in younger age group, and in those with higher disease stage. No significant p value was reached when Ki 67 indexes was correlated with age or with stage of disease in our study. Conclusion: Proliferation marker Ki 67 though lack analytical validation, is still recommended for deciding chemotherapy for breast carcinoma cases. Despite the availability of automated count, manual method is followed in many centers. This study was done to underline the fact that consensus should be reached for uniform assessment of Ki 67 so that the dilemma among pathologists is meted out. The grey zone ki67 index level between 6-30% should be addressed as well for better clarity.