The relationship between Ki-67 index and axillary lymph node metastasis in breast carcinoma

Abstract

Aim: Breast cancer is the most common type of cancer in women. The presence and number of metastatic lymph nodes in the axillaare the most signifiant prognostic factors in breast cancer. In addition, tumor size, lymphovascular invasion, perineural invasion,histopathological type and grade of the tumor are among the best-known prognostic factors. Ki-67 is expressed in G1, S, G2 andM phases of the cell cycle but not in the G0 phase, which allows it to be used as a marker for proliferating cells. The purpose ofthis study is to determine the relationship between Ki-67 Index and classical prognostic factors in breast cancer patients and toinvestigate its effect on axillary lymph node metastasis.Material and Methods: 46 patients, who were diagnosed as breast carcinoma in Sivas Cumhuriyet University Medical Faculty SurgicalOncology Department and who underwent a modifid radical mastectomy and axillary lymph node dissection between 2017 and2019 were included in this study. Histological tumor type, stage, status of axillary lymph nodes and Ki-67 Index were evaluatedretrospectively from the pathology reports of the patients. The patients were grouped under three categories according to Ki-67Index.Results: Regarding the grouping of the patients according to Ki-67 Index, the ones below 15% formed the fist group, between 15-29% the second group, and above 30% the third group. The distribution of the patients according to negativity-positivity of axillarylymph node metastasis in the groups was as fallow: First group, 7 (41.2%) negative - 10 (58.8%) positive; Second group 4 (33.3%)negative - 8 (66.7%) positive; Third Group 3 (17.6%) negative - 14 (82.4%) positive. Of the 46 patients included in the study, 14 (30.4%)were negative for axillary lymph node metastasis and 32 (69.9%) were positive. In our study, the relationship between the increaseof Ki-67 Index and axillary lymph node positivity was found to be statistically signifiant.Conclusion: In this study, we investigated the relationship between Ki-67 Index and classical prognostic markers, especially lymphnode metastasis. Proliferation is an important indicator used to predict prognosis and treatment response in breast cancer. In ourstudy, Ki-67 Index, one of the cell proliferation markers, was found to be positively correlated with axillary lymph node metastasisand other prognostic factors. Therefore, Ki-67 Index was shown to be a signifiant prognostic indicator in breast cancer.