ki67 grade 11 invasive breast cancer - significance of tests

Hi SH1,

Welcome to our Online Community. We hope you find it a good place to seek support. I’m Kirstine, one of the Cancer Information Nurse Specialists.

I’m sorry to read of your recent diagnosis of invasive lobular breast cancer. It’s very reassuring that this was quite small at 10 mm, and that no nodes were involved, and margins were clear at surgery. You mention it being grade 2 I believe (there are 3 grades, and these are often written in Roman numerals so may look like ‘grade II’). Grade 2 means it has an intermediate or medium rate of growth.

Ki67 is a measure that allows doctors to identify how slowly or quickly the cells are dividing and growing and can indicate risk for recurrence, and usefulness of chemotherapy. You are right that Ki67 is considered a low-risk rate of growth. I’m not sure why your consultant expressed surprise – you may need to speak with them more to talk that over. Most early-stage lobular breast cancers will have a low Ki67.

Cancers that are lower risk for recurrence are unlikely to need chemotherapy. We are much better now at identifying cancers that might benefit from chemotherapy and we try to avoid offering it unnecessarily as it can have serious side effects and we don’t want to overtreat cancer or cause harm where it can be avoided.

Oncotyping is a test that can be carried out on a sample of the tumour tissue that has been removed at surgery to assess if chemotherapy might be helpful or is safe to avoid. The criteria for sending a sample for Oncotyping is usually to have:

• an early-stage invasive breast cancer with intermediate risk (grade 2),
• with 0 – 3 lymph nodes affected,
• be oestrogen positive and HER2 negative.

It may help to ask your consultant or breast care nurse about your oestrogen and HER 2 status and whether Oncotyping is appropriate for you or not. It is a commonly requested test, and they will know if it’s wise to arrange it for you.

Most early-stage breast cancers like yours have an incredibly positive outlook. Only a very small proportion of people with a similar diagnosis to you have a raised risk of recurrence and only a very small number would be recommended to have chemotherapy. Your specialist team can advise more on this as they have access to your full medical picture.

Wishing you the very best with this, any future treatments, and your follow up,

Warmest wishes,

Kirstine – Macmillan

Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. Ref KDf/ SB