Utility of Ki67 in predicting response to neoadjuvant chemotherapy in women with locally advanced breast cancer at the Kenyatta national hospital

Mogere, E.O 1, Githaiga J. W1, Owilla F1, Mungania M 2, Ojuka D. K1.

1 Department of surgery, University of Nairobi.

2 Department of Pathology, Kenyatta National Hospital.

Correspondence to: Dr. Mogere Edwin Obiri, Department of Surgery, University of Nairobi. P.O. Box 2715-40200 Kisii. Email: edob40@gmail.com 

Abstract

Background: Ki67 levels have been shown to have good predictive value in breast cancer treatment. There is paucity of data on Ki67 levels in predicting response to neoadjuvant chemotherapy (NACT) in Kenya. This study evaluated the utility of Ki67 in predicting response to NACT.
Methods: This was a prospective observational study carried out at the Kenyatta National Hospital between December 2017 to January 2019 on patients with locally advanced breast cancer. Informed written consent was obtained from the patients following approval by institutional review board. We recruited 61 through consecutive sampling technique. Data collected included patients’ demographics, pre-treatment tumour size, Ki67 levels and tumour biology. After 3 cycles of first line chemotherapy, determination of response was assessed by ultrasonography. Data was analyzed by SPSS for proportion of change in tumour size. The response was correlated with tumor biology and pretreatment levels of Ki67 using Chi-square at a 95% confidence interval and a p-value <0.05 was considered statistically significant. 
Results: The percentage response rate after 3 cycles of NACT was 39.4%, sensitivity and specificity of Ki67 levels was 70.8% and 43.2% respectively with a cut-off value of 32.5%. Conclusions: Ki67 was found to predict response in our context at a rate of 39.4% at 20% cut off after three cycles. 

 

Key words: Ki67, breast cancer, neoadjuvant chemotherapy.

Ann Afr Surg. 2020; **(*):*** DOI:http://dx.doi.org/10.4314/aas.v***.*

Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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