Relationship of Expression Ki67 Pre Neoadjuvant Chemoterapy with Prognosis in Stadium IIIB Breast Cancer Patients that Performed Mastectomy Surgery at Dr. Mohammad Hoesin Hospital Palembang

Abstract

Background: Breast cancer is 42.1 per 100,000 population with an average of 17 deaths per 100,000 population. Breast cancer management includes surgery, radiotherapy, chemotherapy and hormonal therapy. Neoadjuvant therapy has a several goals in breast cancer: reducing the volume of initially inoperable tumors, evaluating in vivo chemosensitivity and analyzing micrometastasis management. Cell proliferation is often measured through Ki67 resulting in independent prognostic markers and as predictive markers of responsiveness or resistance to chemotherapy or endocrine therapy. In breast cancer with high risk has a higher expression of Ki67, so it will have a worse prognosis. This study was conducted to find out the relationship of Ki67 pre chemotherapy neoadjuvant levels with prognosis in patients with stage IIIB breast cancer who performed mastectomy surgery at Moehammad Hoesin Palembang General Hospital.
Method: Cohort Retrospective research on 40 samples Breast cancer patients in the Medical Record Room and Anatomical Pathology Room of Dr. Moehammad Hoesin Palembang in July-September 2021.
Results: There were 14 out of 40 samples that had high Ki67 levels (>30%), chi square and fisher exact analysis showed Ki67 levels >30% were significantly associated with mortality (p<0.05, OR 13,8(2,7-70,2)). At cut off points Ki67 >20% is also significantly associated with mortality (p<0.05, OR 7,1 (0,8-63,1)) with a sensitivity value of 91,6% and specificity of 39,2%.
Conclusion: Ki67 >20% can be a worse prognosis in predicting death and overall survival.