How to get Ki67?

Hi, I am having a mastectomy in a few days with NHS but I was told they do not check Ki67 score for pathology test.

Can anyone advice what private breast cancer clinic offer pathology test including Ki67?

My BC nurse told me that they could send the sample or slide to a private lab if I can find a clinic who test Ki67.

I know that Ki67 is not always tested but when I had a second opinion, the second doctor told me Ki67 should be looked at when they determine treatments.

Has anyone arranged a private pathology test after surgery at NHS?

 

I understand in a certain situation, Oncotype DX is offered to determine chemotherapy, but would NHS offer Oncotype DX if lymph nodes are affected? If not, wouldn’t Ki67 be one of the factors to determine Chemo? 

Sorry I can’t help you with where to get a private test as I had my Ki67 as part of a clinical trial at the Royal Marsden. As far as i know Oncotype is for premenopausal women with clear lymph nodes who are ER positive but with up to 3 nodes affected if post menopausal. All the details are on their website.   My result with Ki67 came back with a low score and onc did not advise chemo despite my having 2 positive nodes so it is worth pursuing.  Perhaps you could contact the Royal Marsden. Good luck with it.

Hi Catokitty,

Thank you for your advice, I agree there are some situations that Ki67 score is used to determine for chemo, for some people they can actually avoid chemo as a result!

I will contact Royal Marsden to find out if they can do it for me.

 

Hi Seren,

This is great, I am contacting Unilabs, too. Thank you for this information.

Also good to know that I can have Oncotype DX with even positive node.

So much to learn within a short period of time before surgery.

 

I hope both of you are coping well after BC treatments.

All the best.

Hi Chica, that is a challenging question, the internet does not throw anything up. I have asked for the Onco DX test, but it is highly unlikely that they will let me have it, as my lobular invasive is Grade 3, but with nodes clear. There is also a EndoPredict study being done in some places, I have been turned down for it, as chemo is the most appropriate and safest treatment for me, despite the mastectomy and no node involvement. An Onco DX can be done in the States, but will set you back around £2,500. So somehow I can understand that they only tend to do this for patients where the need for Chemo, etc is border line.

My understanding is that it is for people who are borderline for chemo & to determine that, they take all of your  factors into account.  If you’re definitely in the chemo camp eg because you have HER2+ or definitely not in the it eg small size, grade 1 there’s no point because they already know what they are doing.  There is a bit about ki67 on the net, but just says over 20 is relevant. I had it done on the NHS in the original path report after op, but no-one mentioned it until it cropped up in a conversation with the Onc about recurrence probabilities after chemo.  All these individual things like size, grade, nodes, ER/PR, HER, ki67 are all just used to form a higher or lower risk picture. For example, I was small tumour, low ki67, clear nodes, ER+ (all positive) but grade 3 & HER2+ (both very aggressive).  They said to me grade 3 plus clear nodes is the same as grade 2 with affected nodes.  It’s sort of a best fit type of thing. Does that make any sense? What I would do is only get oncotype/ki 67 done if they say you’re borderline. Both can be done on the NHS, so say you want referring somewhere that does (they can’t discriminate within the NHS so it’s your right some lady told me on another thread). Good luck with it all. x

Hi All,

Thank you so much for your replies. So good to discuss about treatments, ki 67 etc.

Had the surgery last Friday and now been back home recovering.

 

My NHS doesn’t offer ki67 test but I eventually found a research team who can kindly look at my ki67.

I was told that my BC team will not need to look at ki67 score to determine treatments but I am so relieved that I can have the ki67 score in my hand in case of being borderline to decide chemo treatment then I can speak to someone for a second opinion.

 

I wish all NHS offered ki67 score, I have been told ki67 score is not fully reliable though, we should be all told what OUR cancers are so every result is right in front of us.

 

Thanks and wishing you all the best