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Proliferation Marker Ki-67 in Early Breast Cancer

From the Academic Department of Biochemistry and Breast Unit, Royal Marsden Hospital, London, UK

Address reprint requests to Mitch Dowsett, MD, Academic Department of Biochemistry, Royal Marsden Hospital, Fulham Rd, London SW3 6JJ, United Kingdom; e-mail: mitch.dowsett{at}icr.ac.uk

Molecular markers have been extensively investigated with a view to providing early and accurate information on long-term outcome and prediction of response to treatment of early breast cancer. Proliferation is a key feature of the progression of tumors and is now widely estimated by the immunohistochemical assessment of the nuclear antigen Ki-67. The expression of Ki-67 correlates with other measurements of proliferation, including S-phase and bromodeoxyuridine uptake. High Ki-67 is a sign of poor prognosis associated with a good chance of clinical response to chemotherapy, but its independent significance is modest and does not merit measurements in most routine clinical scenarios. However, its application as a pharmacodynamic intermediate marker of the effectiveness of medical therapy holds great promise for rapid evaluation of new drugs.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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