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    Aurora kinase A outperforms Ki67 as a prognostic marker in ER-positive breast cancer

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    Author
    Ali, HR; Dawson, S-J; Blows, FM; Provenzano, E; Pharoah, PD; Caldas, C
    Date
    2012-05-22
    Source Title
    British Journal of Cancer
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    Dawson, Sarah-Jane; PROVENZANO, ELENA
    Affiliation
    Pathology
    Sir Peter MacCallum Department of Oncology
    Metadata
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    Document Type
    Journal Article
    Citations
    Ali, H. R., Dawson, S. -J., Blows, F. M., Provenzano, E., Pharoah, P. D. & Caldas, C. (2012). Aurora kinase A outperforms Ki67 as a prognostic marker in ER-positive breast cancer. BRITISH JOURNAL OF CANCER, 106 (11), pp.1798-1806. https://doi.org/10.1038/bjc.2012.167.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/258209
    DOI
    10.1038/bjc.2012.167
    Abstract
    BACKGROUND: Proliferation has emerged as a major prognostic factor in luminal breast cancer. The immunohistochemical (IHC) proliferation marker Ki67 has been most extensively investigated but has not gained widespread clinical acceptance. METHODS: We have conducted a head-to-head comparison of a panel of proliferation markers, including Ki67. Our aim was to establish the marker of the greatest prognostic utility. Tumour samples from 3093 women with breast cancer were constructed as tissue microarrays. We used IHC to detect expression of mini-chromosome maintenance protein 2, Ki67, aurora kinase A (AURKA), polo-like kinase 1, geminin and phospho-histone H3. We used a Cox proportional-hazards model to investigate the association with 10-year breast cancer-specific survival (BCSS). Missing values were resolved using multiple imputation. RESULTS: The prognostic significance of proliferation was limited to oestrogen receptor (ER)-positive breast cancer. Aurora kinase A emerged as the marker of the greatest prognostic significance in a multivariate model adjusted for the standard clinical and molecular covariates (hazard ratio 1.3; 95% confidence interval 1.1-1.5; P=0.005), outperforming all other markers including Ki67. CONCLUSION: Aurora kinase A outperforms other proliferation markers as an independent predictor of BCSS in ER-positive breast cancer. It has the potential for use in routine clinical practice.

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