Ki scores

[Jenniferp2122]

hello. Just wanted to reach out and see if anyone knows their Ki score and what their oncologists say about predictability in outcomes. My fathers Ki score is 67-70% which Google has informed me is high. I think this means that it is very Chemo sensitive. Does anyone else have a high Ki score and how did this impact treatment with Ibrance lupron letrozole etc.

[Silver126]

hello my ki initially was 60% and I was on Ribociclib +letrozole for 15 months. I don’t think that chemo sensitivity is higher with high ki. It means that the tumor is fast growing, so aggressive chemo may be an option.

In July I had a liver biopsy and ki wasn’t reported, so I asked why. The onc told me that my my tumor remained er+, and that matters. It’s more indicative for her2+ and triple negative forms of cancer.

[Jenniferp2122 in reply to Silver126]

have you had a poor experience with MBC given that Ki?

[Silver126 in reply to Jenniferp2122]

I was diagnosed de novo in july2020. 15 months on Ribociclib + letrozole, NED after 10 months than spread to liver. Xeloda for 7 months, good results at the beginning, than further spread to liver. Now on Aromasin + Afinitor since August. PET on October 6th and we’ll see🤞🏻🤞🏻🤞🏻My quality of life is good, I’ve never had strong side effects from treatments, but it’s my third line of treatment… I started with breast, lymph nodes, bone lesion in L4.

[Bettybuckets in reply to Silver126]

I also started with breast and a neck Lymph node… in July 2020. They left it in place and use that node as the canary in the coal mine to see if treatment shrinks it or not. I wAnt it radiated and gone.

[DDIL1 in reply to Bettybuckets]

I’m with you, I want my lymph in my armpit radiated and gone but heck no one wants to do that. Are you having any luck?

[Bettybuckets in reply to DDIL1]

well I am in Nz for a month and my former onc suggested it may say my vocal chords from collapsing so will need to work with my USA docs when I get home.

[DDIL1 in reply to Bettybuckets]

I hope your trip is going well!!

[kokopelli2017 in reply to Bettybuckets]

hi Beth. he thinks the 'lymph node' is saving your vocal cords from collapsing? I can't visualize that. will be very interested in what Boston onc has to say. hope your trip is everything you hoped😊

carole XO

[Bettybuckets in reply to kokopelli2017]

Hi dear, I’m may have miscommunicationed. I meant that the Nz oncologist thinks that it may help to radiated the lymph node to stop further damage to my other half of my vocal chord. It is always something isn’t it?

[8576 in reply to Jenniferp2122]

I never check Google anymore. The three that I check is Mayo, John Hokins, and the national cancer center. If it is happening they know about it and you can trust it. I have never had my Ki score checked. In fact this is the first I heard about it.

Cheers, June S.

[Beryl71]

what are ki scores?

[jersey-jazz]

This entry is so good for us. It's the kind of conversation that helps us to know more about what the doctors know and what the doctors are taking into consideration when making these huge decisions for us. To answer the question posed, no, I do not know what my Ki score is. Further, I know nothing about Ki scores. That will change ASAP. Thank you, Jenniferp2122!

[TammyCross]

My "Ki-67 (%)" score was 25, determined by a biopsy of my primary tumor at diagnosis of mbc.

The biopsy report said "Ki-67(MIB-1) % tumor cells positive: 25% No current consensus exists as to the methodological evaluation, optimal cut off and algorithm of clinical usage of the Ki67 labeling index. Proposed cutoffs noted in the literature vary from Unfavorable >10% or >14% or >20% or 30% (St.Gallen). Intermediate 10-14%, 10-20%, 16-30% (St. Gallen). "

So apparently they don't know exactly how to interpret different scores. I had written in caps next to this summary: WHAT DOES FAVORABLE MEAN?

I have not had an answer to that, but Red Azalea accompanied me to my 2nd opinion appointment at MSK and wondered why it was not being discussed in deciding Rx. I think she must know what it means!

Just glanced at a study. It is the percentage of positive cells in a tumor. Apparently, Ki means different things depending on type of breast cancer (HER status, etc.) but is generally associated with prognosis, including metastasis (which we already have), PFS and OS. Maybe this is something we don't want to know. This study found no difference between 14% and 20%.

[kokopelli2017 in reply to TammyCross]

hi Chris.

so if it is the percentage of 'positive' cancer cells in a tumor (sample from biopsy I assume?).....then the percent (whether high or low) gives an indication of how aggressive the cancer is? am I getting that right? I have never heard of Ki scores either.

I wonder if this Ki score is only done on tumor biopsy 'at time of diagnosis'? or do they do them every time you have a biopsy along the journey?

and what does that mean for those who have 'negative' cells.....which I guess just means the absence of any 'positive' cancer cells exist. but that would mean no Ki score if your status is negative? or maybe negative has a different scoring system?

when I was initially diagnosed in 2013 with primary BC and had my R boob amputated, they tested my breast tumor and it was a 'grade 3'. I was told that 'grade' was an indication of aggressiveness. Ki and grade sound the same to me?? or similar?

didn't mean for this to be so long. it's interesting and I am just sort of thinking out loud😉

carole XO

[TammyCross in reply to kokopelli2017]

I will TRY to respond, but really am not sure that I am understanding what I read. Yes, from a biopsy. ba5083 is right -- when I checked this time, ki-67 was the speed at which cells are dividing. The grade is the number of normal compared to abnormal cells. (That sounds like the first definition I go for Ki: % positive cells. I don't think there would be negative cells, only "normal" or positive.)

Ah, grade and Ki correspond: "A Ki-67 index of more than 20% means that more than 2 in every 10 cells (20%) are dividing. This is a grade 3..." So speed means percent dividing? (Then how long does it take them to divide? Are they dividing all the time? Can't be.) I guess speed sounds like aggression. Percent positive cells doesn't, unless positive means dividing.

I don't see a relationship between Ki or grade and response to treatment. My Ki was marginally high, my primary tumor was huge and I had many mets, but I responded to treatments and was NED twice.

[kokopelli2017 in reply to TammyCross]

so from your experience.....no relationship between Ki or grade and treatment response. hmmmm. thanks for reply. XO

[ba5083]

My understanding is Ki is used to determine how aggressive the cancer cells divide. Or one could say how aggressive the cancer is.

Reference Range

Low: <10%

Borderline: 10-20%

High: >20%

Many believe the more aggressive the more receptive it is to traditional Chemo. My understanding is an Oncotype test is what is used to determine if the specific cancer is receptive to traditional Chemo or if another treatment is best suited for the type of cancer that is present.

These were the findings definition we received for ILC (invasive Lobular Carcinoma)

[Jenniferp2122 in reply to ba5083]

that makes sense! I was concerned because my fathers is super high (67-70%) but he is showing a complete response to Ibrance letrozole and lupron and he has only been on it since June. All of his active lesions resolved so I’m keeping my fingers crossed.

[Justme153]

ok so from what I’ve been told is KI-67 was being used to help determine the aggressiveness of cancer. If your cancer cells are dividing rapidly then chemo would be used as treatment. But chemo only works on fast dividing cells and has little affect on slow division. So they where trying to help cancer patients out by avoiding chemo if they where slow division. The problem came with a machine that is used to process this particular test. They found a few years into this processs that not all hospitals and labs where using the specific machine that this test was approved for for its accuracy . So the methods that where being used where not as accurate as believed. So once this was brought to the surface a lot of oncologists will not use the KI-67 findings. There seems to be a over all trust in the ONCO DX test which also tells how rapidly the cells are dividing. From what I can gather some doctors like to use both if there is a boarder line reading on the ONCO test they would use the KI-67 test results to see if it is also close. This is just my understanding from articles I have read I could be wrong so please ask your own doctor his opinion .

[TammyCross in reply to Justme153]

That sounds like the most reasonable or knowledgeable response.

[Hidden]

Hi Jennifer! My Ki-67 score was 60% and it was a factor in developing the treatment plan because my tumor was growing so quickly. Throwing the motherload of chemo was the best course of action to first contain it and then shrink it as much as possible before surgery. I had stage IIA invasive lobular.

[Jenniferp2122 in reply to Hidden]

did the chemo respond well?

[Hidden in reply to Jenniferp2122]

100% responded well enough to get great margins when I had my lumpectomy. I had 4 AC and 12 Taxol. I'm intolerant of all AI meds even after being surgically put into menopause. I had all the rare side effects, so I have been on no post-treatment meds since 2017. I also had 33 rounds of radiation. I'm a 6-year survivor.