High Ki67 expression is a risk marker of invasive relapse for classical lobular carcinoma in situ patients

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• 作者：Anne Vincent-Salomon^a ; ^b ; ^{anne.salomon@curie.net} ; David Hajage^c ; Alexandre Rouquette^a ; Auré ; lie Cé ; denot^a ; Nadè ; ge Gruel^b ; Sé ; verine Alran^d ; Xavier Sastre-Garau^a ; Brigitte Sigal-Zafrani^a ; Alain Fourquet^e ; Youlia Kirova^e
• 关键词：Breast carcinoma ; Lobular carcinoma in situ ; KI67 ; Proliferation ; Relapse risk
• 刊名：The Breast
• 出版年：2012
• 期刊代码：321_09609776
• 类别：med
• 出版时间：June, 2012
• 卷：21
• 期：3
• 页码：380-383
• 文件大小：500 K

摘要

Background

The clinical management of lobular carcinoma in situ lesions remains challenging. Our aim was to evaluate the risk of relapse for lobular carcinoma in situ (LCIS) patients, diagnosed on mammography performed for microcalcifications and according to proliferation assessed by Ki67 staining.

Methods

A series of 47 patient's files with LCIS and followed in our institution were retrospectively selected. All patients underwent lumpectomy without radiation therapy. The expression of E-cadherin, estrogen receptor (ER), progesterone receptor (PR), EGFR and Ki67 were determined. Four different classes were then defined with the following criteria: ER+ and Ki67聽鈮ぢ?0%; ER+, Ki67聽>聽10%; ER鈭? ER-PR鈭?and EGFR+.

Results

Patient's mean age was 51.3聽yrs. The majority of the lesions were classical LCIS (97%). All cases were E-cadherin either negative (71%) or weak and incomplete (29%). Among the 44 evaluable cases, 34 cases were ER or PR positive with KI67聽鈮ぢ?0%(79%), 9 cases ER positive with KI67聽>聽10%(21%), 1 case was ER and PR negative and expressed EGFR. At five years, all patients were alive, 1/34 ER positive and Ki67 low experienced a relapse contrasting with 3 out of 9 ER positive and Ki67 high (3 invasive carcinomas including 2 ductal and 1 lobular) (p聽=聽0.0054).

Conclusion

In this retrospective study, we observed a higher risk of relapse associated with a high proliferative activity of classical LCIS. If confirmed in larger series, this observation suggests that radiation therapy or hormonotherapy could be discussed for patients with Ki67 high classical LCIS in order to decrease their risk of relapse.