Article thumbnail
Location of Repository

Evaluation of ER, PgR, HER-2 and Ki-67 as predictors of response to neoadjuvant anthracycline chemotherapy for operable breast cancer

By R J Burcombe, A Makris, P I Richman, F M Daley, S Noble, M Pittam, D Wright, S A Allen, J Dove and G D Wilson


Primary systemic therapy (PST) for operable breast cancer enables the identification of in vivo biological markers that predict response to treatment. A total of 118 patients with T2–4 N0–1 M0 primary breast cancer received six cycles of anthracycline-based PST. Clinical and radiological response was assessed before and after treatment using UICC criteria. A grading system to score pathological response was devised. Diagnostic biopsies and postchemotherapy surgical specimens were stained for oestrogen (ER) and progesterone (PgR) receptor, HER-2 and cell proliferation (Ki-67). Clinical, radiological and pathological response rates were 78, 72 and 38%, respectively. There was a strong correlation between ER and PgR staining (P<0.0001). Higher Ki-67 proliferation indices were associated with PgR− tumours (median 28.3%, PgR+ 22.9%; P=0.042). There was no relationship between HER-2 and other biological markers. No single pretreatment or postchemotherapy biological parameter predicted response by any modality of assessment. In all, 10 tumours changed hormone receptor classification after chemotherapy (three ER, seven PgR); HER-2 staining changed in nine cases. Median Ki-67 index was 24.9% before and 18.1% after treatment (P=0.02); the median reduction in Ki-67 index after treatment was 21.2%. Tumours displaying >75% reduction in Ki-67 after chemotherapy were more likely to achieve a pathological response (77.8 vs 26.7%, P=0.004)

Topics: Molecular Diagnostics
Publisher: Nature Publishing Group
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (1998). A reduction in the requirements for mastectomy in a randomized trial of neoadjuvant chemoendocrine therapy in primary breast cancer.
  2. (1998). Cytotoxic and antiproliferative activity of the CMF regimen administered in association with tamoxifen as primary chemotherapy in breast cancer patients.
  3. (1993). DNA flow cytometry and pathologic grading as prognostic guides in axillary lymph node-negative breast cancer.
  4. (1990). Does the oestrogen receptor concentration of a breast cancer change during systemic therapy?
  5. (1998). erbB-2, p53, and efficacy of adjuvant therapy in lymph node-positive breast cancer.
  6. (2003). Influence of neoadjuvant therapy with epirubicin and docetaxel on the expression of HER2/neu in patients with breast cancer.
  7. (1992). Neoadjuvant chemotherapy in 126 operable breast cancers.
  8. (1996). Prognostic value of histopathological therapeutic effects and mitotic index in locally advanced breast cancers after neoadjuvant chemotherapy.
  9. (1980). Quantitative estrogen receptor analyses: the response to endocrine and cytotoxic chemotherapy in human breast cancer and the disease-free interval.
  10. (1987). Relation of ploidy and S-phase fraction to outcome of patients in NSABP B-04. Cancer 68: 1465–1475 Fornage
  11. (1998). Surg 125: 107–113 Allred
  12. (1996). Tumor proliferative activity and response to first-line chemotherapy in advanced breast carcinoma.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.