Utility of Ki67 in Predicting Response to Neoadjuvant Chemotherapy in Women With Locally Advanced Breast Cancer at the Kenyatta National Hospital.
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Date
2019Author
Mogere, Edwin Obiri
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Background: In Kenya, majority present with locally advanced breast cancer. Neoadjuvant
chemotherapy(NACT) is useful in management of these patients, and is useful in predicting
response to treatment. Ki67 levels have good prediction and prognosticating value in breast
cancer treatment. There is limited data on Ki67 in Kenya. This study deciphers the role of Ki67
in predicting response to NACT.
Patients and methods:
This was a prospective cohort study carried out at the Kenyatta National Hospital. Women with
locally advanced breast cancer, who met the inclusion criteria, were recruited consecutively and
followed up over a period of six months from December 2017 to January 2019. Informed consent
was sort and data obtained included pre-treatment tumour size by ultrasound, pre-treatment Ki67
levels, demography, tumour biology was collected.On completion of 3 cycles of first line
chemotherapy, response by useof ultrasound was done. Response was defined as tumor reduction
by 30% from the pretreatment size. Data was analyzed by using of SPSS (V 21.0). We analyze
change in tumour size, tumour biology and compared them with pretreatment Ki67 levels.
Results:The mean age was 45.9 (SD=10.4) years.The disease status on completion of 3 cycles
was response at 39.4%, stable disease 50.8% and progressive disease is 9.8%. The sensitivity
and specificity of Ki67 was 70.8% and 43.2% respectively ata cut off value of 32.5%. There was
no association between lymphovascular invasion and KI67 levels, χ2 (1) = 2.198, p = .138, but
there was statistically significant association between perineural invasion and KI67 levels, χ2 (1)
= 10.509, p = .005.
Conclusions: The cut off of Ki67 in this study is high at 39.4%.Majority of patient have stable
disease on completion of the third cycle. In our study the only aspect of tumour biology that has
some association with higher Ki67 is perineural invasion.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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