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Proliferative markers such as Ki\u201067, mini chromosome maintenance (MCM) proteins, and proliferating cell nuclear antigen (PCNA) offer valuable insights into tumor growth and treatment response. This review evaluates their clinical roles, with a focus on chemotherapy implications and emerging digital pathology techniques for marker quantification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A narrative review was conducted by searching PubMed, Scopus, and Google Scholar for studies related to Ki\u201067, MCM, PCNA, breast cancer, and chemotherapy. Studies were thematically categorized into five areas. A bibliometric analysis of publications from 2000 to April 2023 was performed using the Bibliometrix R package and VOSviewer to assess research trends and thematic evolution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty studies were included in the narrative synthesis. Ki\u201067 is the most commonly used marker, particularly useful in predicting response to neoadjuvant chemotherapy (NAC). MCM proteins show promise for identifying proliferative potential across tumor grades, while PCNA is associated with aggressive tumor features and poor prognosis. Post\u2010chemotherapy changes in Ki\u201067 levels are linked to survival outcomes. Bibliometric analysis revealed a shift in research focus from basic mechanisms to clinical applications and digital quantification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Proliferative markers play an essential role in breast cancer management. Ki\u201067 remains a key predictor of chemotherapy response, while MCM and PCNA offer complementary prognostic insights. Integration of these markers with digital pathology and AI\u2010driven tools may enhance diagnostic accuracy and personalized treatment strategies. Standardization of assessment methods is crucial for broader clinical application.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.70626","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T15:38:26Z","timestamp":1744126706000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Proliferative Markers in Breast Cancer and Chemotherapy Implications: A Comprehensive Review"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6772-0972","authenticated-orcid":false,"given":"Aryan","family":"Salahi\u2010Niri","sequence":"first","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0643-4059","authenticated-orcid":false,"given":"Paniz","family":"Zarand","sequence":"additional","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5972-9953","authenticated-orcid":false,"given":"Fatemeh","family":"Shojaeian","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Research Center Johns Hopkins School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negar","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omid","family":"Yazdani","sequence":"additional","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Esbati","sequence":"additional","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9295-9283","authenticated-orcid":false,"given":"Seyed Amir Ahmad","family":"Safavi\u2010Naini","sequence":"additional","affiliation":[{"name":"Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research, Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences Tehran Iran"},{"name":"Division of Data\u2010Driven and Digital Medicine (D3M) Icahn School of Medicine at Mount Sinai New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2762-5591","authenticated-orcid":false,"given":"Behnaz","family":"Jahanbin","sequence":"additional","affiliation":[{"name":"Cancer Institute, Pathology Department, Imam Khomeini Hospital Complex Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20211033"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2174\/1381612819666131125145517"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers2010190"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/cco.2019.08.02"},{"key":"e_1_2_11_6_1","unstructured":"T.Chakrabortty C. 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