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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]
  High thymidine labelling index correlates with worse relapse-free and overall survival (significance differs by subgroups, p = 0.16 to 0.0002) [2,11]
  Measures of S-phase fraction and DNA ploidy by flow cytometry can predict for disease-free and overall survival (p = 0.007) [12]
  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]
  Changes in FLT-PET uptake after one cycle of chemotherapy predict eventual response on CT-imaging (r = 0.79) [101]
  1. FLT, 3'-deoxy-3'-fluorothymidine; PET, positron emission tomography. an individual patient on the basis of lack of Ki67 reduction alone.