Topics:
Breast Cancer • Medical Oncology • HR+ • Breast Cancer, Non-metastatic • Her2-negative breast cancer
How and on which specimens will you perform Ki-67 testing in newly diagnosed breast cancer?
Should this be sent on initial biopsy or on surgical pathology? What if an initially high risk patient has good risk findings post-operatively?
What has been your experience accessing the companion diagnostic (Dako Omnis)? Can results from other testing, including local pathology, be used in determining eligibility for adjuvant abemaciclib per MonarchE?
Answer from: Medical Oncologist at Academic Institution
Likely, this will depend on the institutional standard. Our group at Magee Women's Hospital has extensive experience with Ki67 on core biopsy and it is part of our standard biomarker workup. Other institutions may perform this differently. We may start performing Ki67 on the resected tumor if the in...
Answer from: Medical Oncologist at Community Practice
Many studies confirm that Ki67 is prognostic in early-stage breast cancer. However, these studies display substantial variability in both analytical validity and choice of cutoffs, and most have been studies of convenience in which selection of patients, the intrinsic subtypes of the cancers, and ap...
Answer from: Medical Oncologist at Academic Institution
The requirement for the Ki-67 testing is problematic. In the trial, the benefit for abemaciclib was greater if Ki-67 was high, but still existed if Ki-67 was not high. In talking to our pathologists and lab, we learned that Ki-67 is a very difficult test to run and results can be very variable. So, ...
The details are critical and it is hard to ask a c...