Ki-67 Changes Before And After Neoadjuvant Chemotherapy Is A Prognostic Marker In Breast Cancer

High Ki-67 expression in breast cancer is generally considered to be associated with poor prognosis.For patients receiving neoadjuvant chemotherapy(NAC),a large proportion of patients still find residual tumors during surgery.We can detect two sets of biological markers in the needle biopsy specimens before neoadjuvant chemotherapy and the surgical specimens after neoadjuvant chemotherapy.The changes in Ki-67 expression before and after neoadjuvant chemotherapy can be frequently observed in the clinic.We hypothesized that the decrease in Ki-67 expression may indicate neoadjuvant chemotherapy reduced the tumor cell proliferation activity,thereby reducing the risk of recurrence and metastasis.Therefore,we reviewed 165 patients who underwent biopsy before neoadjuvant chemotherapy and then took a radical mastectomy in our hospital,and observe whether the changes in Ki-67 before and after neoadjuvant chemotherapy would affect recurrence and metastasis.The results showed that Ki-67 after NAC in the non-relapsed metastasis group was lower than that in the relapsed metastasis group(p=0.000).The non-relapsed metastasis group have higher difference between Ki-67 before and after NAC than that in the relapsed metastasis group(p=0.000).The rate of Ki-67 decline in nonrelapsed metastasis group was significantly higher than that in relapsed metastasis group(p=0.008).The change of Ki-67 before and after is an independent factor affecting the recurrence and metastasis of the disease(p=0.012).The decrease of Ki-67 may be an important predictor of recurrence and metastasis of breast cancer two years later.This result indicates that in addition to take Ki-67 expression before and after neoadjuvant chemotherapy,we also need to pay attention to the changes,which can guide clinicians to more fully judge the risk of disease recurrence and metastasis,and then take corresponding treatment measures.