Table 2 Clinical applications of measures of proliferation in breast cancer
From: Measuring proliferation in breast cancer: practicalities and applications
Application | Evidence | Reference |
|---|---|---|
Prognostic indicator | High mitotic count predictive of risk of breast cancer death (relative risk = 2.8) | [1] |
| Â | High thymidine labelling index correlates with worse relapse-free and overall survival (significance differs by subgroups, p = 0.16 to 0.0002) | [2,11] |
| Â | Measures of S-phase fraction and DNA ploidy by flow cytometry can predict for disease-free and overall survival (p = 0.007) | [12] |
| Â | On multivariate analysis Ki67 score is independently predictive of disease-free survival (p = 0.038) and relapse free survival (p = 0.03) | [29,34] |
|  | High expression of cyclins A and E associated with poor prognosis | [45–50] |
Planning adjuvant treatment | In some studies the prognostic value of proliferation index is particularly significant in patients with T1 and/or node negative tumours (in whom chemotherapy might not otherwise be advised) | [34,36] |
Prediction of response | Changes in Ki67 after one cycle of chemotherapy predict eventual clinical response (p = 0.05) | [104] |
| Â | Changes in FLT-PET uptake after one cycle of chemotherapy predict eventual response on CT-imaging (r = 0.79) | [101] |