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Prognostic significance of pathologic complete response and Ki67 expression after neoadjuvant chemotherapy in breast cancer

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Title: Prognostic significance of pathologic complete response and Ki67 expression after neoadjuvant chemotherapy in breast cancer
Authors: Yoshioka, Tatsuya Browse this author
Hosoda, Mitsuchika Browse this author →KAKEN DB
Yamamoto, Mitsugu Browse this author
Taguchi, Kazunori Browse this author
Hatanaka, Kanako C. Browse this author
Takakuwa, Emi Browse this author
Hatanaka, Yutaka Browse this author →KAKEN DB
Matsuno, Yoshihiro Browse this author
Yamashita, Hiroko Browse this author →KAKEN DB
Keywords: Breast cancer
Neoadjuvant chemotherapy
Pathologic complete response
Issue Date: Mar-2015
Publisher: Springer Japan Kk
Journal Title: Breast Cancer
Volume: 22
Issue: 2
Start Page: 185
End Page: 191
Publisher DOI: 10.1007/s12282-013-0474-2
PMID: 23645542
Abstract: Recent studies have indicated that response to chemotherapy and the prognostic impact of a pathologic complete response (pCR) after neoadjuvant chemotherapy differ among breast cancer subtypes. Women with Stage I to III breast cancer treated with anthracycline and taxane-based neoadjuvant chemotherapy (four cycles of docetaxel every 3 weeks followed by four cycles of FEC every 3 weeks) between 2006 and 2011 were retrospectively analyzed. Trastuzumab was concurrently added to docetaxel for HER2-positive breast cancer. Expression of estrogen receptor (ER), progesterone receptor (PgR), HER2, and Ki67 was examined by immunohistochemistry in pre- and post-treatment specimens. Predictive factors for neoadjuvant chemotherapy and prognosis were analyzed by breast cancer subtype. Of 64 patients, 30 (47 %) were ER-positive (ER+) HER2-negative (HER2-), including eight as luminal A (Ki67 labeling index (LI) < 14 %) and 22 as luminal B (Ki67 LI a parts per thousand yen 14 %) subtypes, 11 (17 %) were ER+ HER2-positive (HER2+), 12 (19 %) were ER-negative (ER-) HER2+, and 11 (17 %) were ER- HER2-. The clinical response rates were significantly higher in luminal B, ER+ HER2+, and ER- HER2+ subtypes compared with luminal A subtype. Patients whose tumors contained high Ki67 expression effectively responded to neoadjuvant chemotherapy. Ki67 LI was a predictive marker for pCR, and all patients whose tumors achieved pCR are currently disease-free. Furthermore, high Ki67 expression in post-treatment tumors was strongly correlated with poor disease-free and overall survival regardless of subtype. It is necessary to establish additional strategies to improve survival for patients whose residual tumors show high Ki67 expression after neoadjuvant chemotherapy.
Rights: The final publication is available at
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 山下 啓子

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