{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:45:28Z","timestamp":1792071928599,"version":"4.4.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer Res Treat"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>This study aimed to identify the association between Ki-67 level and the prognosis of patients with breast cancer, regardless of the timing of Ki-67 testing (using preoperative biopsy vs. postoperative specimen).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 4177 patients underwent surgery between January 2008 and December 2016. Immunohistochemical Ki-67 levels, using either preoperative (1673) or postoperative (2831) specimens, were divided into four groups using cutoff points of 10%, 15%, and 20%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Groups with higher-Ki-67 levels, in both the pre- and postoperative periods, showed significantly larger tumor size, higher grade, more frequent hormone receptor-negativity and human epidermal growth factor receptor 2 overexpression, and active adjuvant treatments than groups with lower-Ki-67 levels. High-Ki-67 levels were also significantly associated with poor survival, irrespective of the timing of specimen examination.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Despite the problems associated with Ki-67, Ki-67 level is an important independent prognostic factor, regardless of the timing of Ki-67 testing, i.e., preoperative or postoperative testing.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-022-06519-1","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T13:02:48Z","timestamp":1642078968000},"page":"343-352","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Ki-67 and breast cancer prognosis: does it matter if Ki-67 level is examined using preoperative biopsy or postoperative specimen?"],"prefix":"10.1007","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0795-3851","authenticated-orcid":false,"given":"Soon Bo","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Min","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee Hyun","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieon","family":"Go","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeeye","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Seok","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Il","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byeong-Woo","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8089-2755","authenticated-orcid":false,"given":"Seho","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,13]]},"reference":[{"issue":"19","key":"6519_CR1","doi-asserted-by":"publisher","first-page":"10869","DOI":"10.1073\/pnas.191367098","volume":"98","author":"T S\u00f8rlie","year":"2001","unstructured":"S\u00f8rlie T et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci 98(19):10869\u201310874","journal-title":"Proc Natl Acad Sci"},{"issue":"14","key":"6519_CR2","doi-asserted-by":"publisher","first-page":"8418","DOI":"10.1073\/pnas.0932692100","volume":"100","author":"T S\u00f8rlie","year":"2003","unstructured":"S\u00f8rlie T et al (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci 100(14):8418\u20138423","journal-title":"Proc Natl Acad Sci"},{"issue":"27","key":"6519_CR3","doi-asserted-by":"publisher","first-page":"2817","DOI":"10.1056\/NEJMoa041588","volume":"351","author":"S Paik","year":"2004","unstructured":"Paik S et al (2004) A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med 351(27):2817\u20132826","journal-title":"N Engl J Med"},{"issue":"9","key":"6519_CR4","doi-asserted-by":"publisher","first-page":"2206","DOI":"10.1093\/annonc\/mdt303","volume":"24","author":"A Goldhirsch","year":"2013","unstructured":"Goldhirsch A et al (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 24(9):2206\u20132223","journal-title":"Ann Oncol"},{"issue":"1","key":"6519_CR5","first-page":"616","volume":"17","author":"N Arima","year":"2019","unstructured":"Arima N et al (2019) Ki-67 index value and progesterone receptor status can predict prognosis and suitable treatment in node-negative breast cancer patients with estrogen receptor-positive and HER2-negative tumors. Oncol Lett 17(1):616\u2013622","journal-title":"Oncol Lett"},{"issue":"8","key":"6519_CR6","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1093\/annonc\/mdr304","volume":"22","author":"A Goldhirsch","year":"2011","unstructured":"Goldhirsch A et al (2011) Strategies for subtypes\u2014dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22(8):1736\u20131747","journal-title":"Ann Oncol"},{"issue":"28","key":"6519_CR7","doi-asserted-by":"publisher","first-page":"7212","DOI":"10.1200\/JCO.2005.07.501","volume":"23","author":"A Urruticoechea","year":"2005","unstructured":"Urruticoechea A, Smith IE, Dowsett M (2005) Proliferation marker Ki-67 in early breast cancer. J Clin Oncol 23(28):7212\u20137220","journal-title":"J Clin Oncol"},{"issue":"1","key":"6519_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1365-2184.1996.tb00090.x","volume":"29","author":"M Duchrow","year":"1996","unstructured":"Duchrow M et al (1996) Molecular characterization of the gene locus of the human cell proliferation-associated nuclear protein defined by monoclonal antibody Ki-67. Cell Prolif 29(1):1\u201312","journal-title":"Cell Prolif"},{"issue":"2","key":"6519_CR9","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.pathol.2016.11.006","volume":"49","author":"F Penault-Llorca","year":"2017","unstructured":"Penault-Llorca F, Radosevic-Robin N (2017) Ki67 assessment in breast cancer: an update. Pathology 49(2):166\u2013171","journal-title":"Pathology"},{"issue":"10","key":"6519_CR10","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1038\/sj.bjc.6603756","volume":"96","author":"E de Azambuja","year":"2007","unstructured":"de Azambuja E et al (2007) Ki-67 as prognostic marker in early breast cancer: a meta-analysis of published studies involving 12,155 patients. Br J Cancer 96(10):1504\u20131513","journal-title":"Br J Cancer"},{"issue":"10","key":"6519_CR11","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1093\/jnci\/djp082","volume":"101","author":"MC Cheang","year":"2009","unstructured":"Cheang MC et al (2009) Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst 101(10):736\u2013750","journal-title":"J Natl Cancer Inst"},{"issue":"5","key":"6519_CR12","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1245\/s10434-009-0334-7","volume":"16","author":"S-Y Jung","year":"2009","unstructured":"Jung S-Y et al (2009) Ki-67 Expression Gives Additional Prognostic Information on St. Gallen 2007 and Adjuvant! Online Risk Categories in Early Breast Cancer. Ann Surg Oncol 16(5):1112\u20131121","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"6519_CR13","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1159\/000346475","volume":"84","author":"K Kontzoglou","year":"2013","unstructured":"Kontzoglou K et al (2013) Correlation between Ki67 and breast cancer prognosis. Oncology 84(4):219\u2013225","journal-title":"Oncology"},{"issue":"22","key":"6519_CR14","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.1093\/jnci\/djr393","volume":"103","author":"M Dowsett","year":"2011","unstructured":"Dowsett M et al (2011) Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst 103(22):1656\u20131664","journal-title":"J Natl Cancer Inst"},{"issue":"2","key":"6519_CR15","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s10549-016-3950-5","volume":"159","author":"CM Focke","year":"2016","unstructured":"Focke CM, van Diest PJ, Decker T (2016) St Gallen 2015 subtyping of luminal breast cancers: impact of different Ki67-based proliferation assessment methods. Breast Cancer Res Treat 159(2):257\u2013263","journal-title":"Breast Cancer Res Treat"},{"key":"6519_CR16","doi-asserted-by":"crossref","unstructured":"Chu P-Y, et al (2016) Risk factors associated with discordant ki-67 levels between preoperative biopsy and postoperative surgical specimens in breast cancers. Plos One 11(3)","DOI":"10.1371\/journal.pone.0151054"},{"issue":"3","key":"6519_CR17","doi-asserted-by":"publisher","first-page":"364","DOI":"10.5858\/arpa.2017-0014-OA","volume":"142","author":"S Ahn","year":"2018","unstructured":"Ahn S et al (2018) Evaluation of Ki-67 index in core needle biopsies and matched breast cancer surgical specimens. Arch Pathol Lab Med 142(3):364\u2013368","journal-title":"Arch Pathol Lab Med"},{"issue":"2","key":"6519_CR18","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1097\/PAI.0000000000000268","volume":"25","author":"A Al Nemer","year":"2017","unstructured":"Al Nemer A (2017) The performance of Ki-67 Labeling index in different specimen categories of invasive ductal carcinoma of the breast using 2 scoring methods. Appl Immunohistochem Mol Morphol 25(2):86\u201390","journal-title":"Appl Immunohistochem Mol Morphol"},{"issue":"4","key":"6519_CR19","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/s00428-020-02818-4","volume":"477","author":"KA Tendl-Schulz","year":"2020","unstructured":"Tendl-Schulz KA et al (2020) Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens. Virchows Arch 477(4):545\u2013555","journal-title":"Virchows Arch"},{"issue":"7","key":"6519_CR20","doi-asserted-by":"publisher","first-page":"e48","DOI":"10.5858\/134.7.e48","volume":"134","author":"MEH Hammond","year":"2010","unstructured":"Hammond MEH et al (2010) American Society of Clinical Oncology\/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version). Arch Pathol Lab Med 134(7):e48\u2013e72","journal-title":"Arch Pathol Lab Med"},{"issue":"2","key":"6519_CR21","doi-asserted-by":"publisher","first-page":"241","DOI":"10.5858\/arpa.2013-0953-SA","volume":"138","author":"AC Wolff","year":"2014","unstructured":"Wolff AC et al (2014) Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology\/College of American Pathologists clinical practice guideline update. Arch Pathol Lab Med 138(2):241\u2013256","journal-title":"Arch Pathol Lab Med"},{"issue":"3","key":"6519_CR22","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1093\/annonc\/mdt528","volume":"25","author":"S Gandini","year":"2014","unstructured":"Gandini S et al (2014) Association of molecular subtypes with Ki-67 changes in untreated breast cancer patients undergoing pre-surgical trials. Ann Oncol 25(3):618\u2013623","journal-title":"Ann Oncol"},{"issue":"3","key":"6519_CR23","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1007\/s10549-019-05198-9","volume":"175","author":"PA Fasching","year":"2019","unstructured":"Fasching PA et al (2019) Prognostic effect of Ki-67 in common clinical subgroups of patients with HER2-negative, hormone receptor-positive early breast cancer. Breast Cancer Res Treat 175(3):617\u2013625","journal-title":"Breast Cancer Res Treat"},{"key":"6519_CR24","first-page":"7386734","volume":"2019","author":"Y-J Kang","year":"2019","unstructured":"Kang Y-J et al (2019) Ki-67 Expression is a significant prognostic factor only when progesterone receptor expression is low in estrogen receptor-positive and HER2-negative early breast Cancer. J Oncol 2019:7386734","journal-title":"J Oncol"},{"key":"6519_CR25","doi-asserted-by":"crossref","unstructured":"Zhu X, et al. (2020) The prognostic and predictive potential of Ki-67 in triple-negative breast cancer. Sci Rep 10(1)","DOI":"10.1038\/s41598-019-57094-3"},{"key":"6519_CR26","doi-asserted-by":"publisher","first-page":"1068","DOI":"10.3389\/fonc.2019.01068","volume":"9","author":"Q Wu","year":"2019","unstructured":"Wu Q et al (2019) Prognostic value of Ki-67 in patients with resected triple-negative breast cancer: a meta-analysis. Front Oncol 9:1068","journal-title":"Front Oncol"},{"issue":"3","key":"6519_CR27","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s10549-015-3559-0","volume":"153","author":"F Petrelli","year":"2015","unstructured":"Petrelli F et al (2015) Prognostic value of different cut-off levels of Ki-67 in breast cancer: a systematic review and meta-analysis of 64,196 patients. Breast Cancer Res Treat 153(3):477\u2013491","journal-title":"Breast Cancer Res Treat"},{"issue":"2","key":"6519_CR28","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s10549-016-3817-9","volume":"157","author":"S Bustreo","year":"2016","unstructured":"Bustreo S et al (2016) Optimal Ki67 cut-off for luminal breast cancer prognostic evaluation: a large case series study with a long-term follow-up. Breast Cancer Res Treat 157(2):363\u2013371","journal-title":"Breast Cancer Res Treat"},{"issue":"1","key":"6519_CR29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-016-0028-x","volume":"7","author":"M Saha","year":"2017","unstructured":"Saha M et al (2017) An advanced deep learning approach for Ki-67 stained hotspot detection and proliferation rate scoring for prognostic evaluation of breast cancer. Sci Rep 7(1):1\u201314","journal-title":"Sci Rep"},{"key":"6519_CR30","doi-asserted-by":"crossref","unstructured":"Razavi S, et al (2018) An automated and accurate methodology to assess ki-67 labeling index of immunohistochemical staining images of breast cancer tissues. In: 2018 25th International Conference on Systems, Signals and Image Processing (IWSSIP). IEEE","DOI":"10.1109\/IWSSIP.2018.8439184"},{"issue":"7","key":"6519_CR31","doi-asserted-by":"publisher","first-page":"e0119565","DOI":"10.1371\/journal.pone.0119565","volume":"10","author":"R Tashima","year":"2015","unstructured":"Tashima R et al (2015) Evaluation of an Optimal Cut-Off Point for the Ki-67 Index as a Prognostic Factor in Primary Breast Cancer: A Retrospective Study. PLoS ONE 10(7):e0119565\u2013e0119565","journal-title":"PLoS ONE"},{"issue":"10","key":"6519_CR32","doi-asserted-by":"publisher","first-page":"5588","DOI":"10.1245\/s10434-021-10457-5","volume":"28","author":"JIJ Orozco","year":"2021","unstructured":"Orozco JIJ et al (2021) Is the 21-Gene recurrence score on core needle biopsy equivalent to surgical specimen in early-stage breast cancer? A comparison of gene expression between paired core needle biopsy and surgical specimens. Ann Surg Oncol 28(10):5588\u20135596","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"6519_CR33","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/s10549-020-06075-6","volume":"186","author":"P Qi","year":"2021","unstructured":"Qi P et al (2021) Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients. Breast Cancer Res Treat 186(2):327\u2013342","journal-title":"Breast Cancer Res Treat"}],"container-title":["Breast Cancer Research and Treatment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-022-06519-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10549-022-06519-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10549-022-06519-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T20:10:17Z","timestamp":1647461417000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10549-022-06519-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,13]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["6519"],"URL":"https:\/\/doi.org\/10.1007\/s10549-022-06519-1","relation":{},"ISSN":["0167-6806","1573-7217"],"issn-type":[{"value":"0167-6806","type":"print"},{"value":"1573-7217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,13]]},"assertion":[{"value":"14 November 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board of Severance Hospital, Seoul, Republic of Korea (IRB No. 4\u20132020-1293) approved this study. The requirement for informed consent was waived due to the retrospective nature of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The requirement for informed consent was waived due to the retrospective nature of the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publish"}}]}}