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Vidal Laliena, MiriamAuthorMartin Pena, MerceAuthorGonzalez Franquesa, AlbaAuthorFernandez-Martinez AAuthorPascual TAuthorGalvan PAuthorPare LAuthorAlonso IAuthorFernandez PAuthorAdamo, BAuthorMunoz MAuthorViladot MAuthorFont CAuthorAya FCorresponding AuthorVidal MCorresponding AuthorVidal, MAuthorCarrasco EAuthorPrat ACorresponding AuthorMartin MCorresponding Author

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April 11, 2017
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Article

Limitations in predicting PAM50 intrinsic subtype and risk of relapse score with Ki67 in estrogen receptor-positive HER2- negative breast cancer

Publicated to: Oncotarget. 8 (13): 21930-21937 - 2017-03-28 8(13), DOI: 10.18632/oncotarget.15748

Authors:

Fernandez-Martinez, Aranzazu; Pascual, Tomas; Perrone, Giuseppe; Morales, Serafin; de la Haba, Juan; Gonzalez-Rivera, Milagros; Galvan, Patricia; Zalfa, Francesca; Amato, Michela; Gonzalez, Lucia; Prats, Miquel; Rojo, Federico; Manso, Luis; Pare, Laia; Alonso, Immaculada; Albanell, Joan; Vivancos, Ana; Gonzalez, Antonio; Matito, Judit; Gonzalez, Sonia; Fernandez, Pedro; Adamo, Barbara; Munoz, Montserrat; Viladot, Margarita; Font, Carme; Aya, Francisco; Vidal, Maria; Caballero, Rosalia; Carrasco, Eva; Altomare, Vittorio; Tonini, Giuseppe; Prat, Aleix; Martin, Miguel
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Affiliations

Arnau de Vilanova Lleida Univ Hosp, Dept Med Oncol, Lleida, Spain - Author
August Pi i Sunyer Biomed Res Inst, Translat Genom & Targeted Therapeut Solid Tumors, Barcelona, Spain.      IDIBAPS    University of Barcelona    Hospital Clinic de Barcelona - Author
August Pi i Sunyer Biomed Res Inst, Translat Genom & Targeted Therapeut Solid Tumors, Barcelona, Spain      University of Barcelona    IDIBAPS    Hospital Clinic de Barcelona - Author
Dept Med, Univ Campus Biomed Roma, Rome, Italy      University Campus Bio-Medico - Rome Italy       - Author
Doce de Octubre Hosp, Dept Med Oncol, Madrid, Spain      Hospital Universitario 12 de Octubre - Author
Fdn Jimenez Diaz Hlth Res Inst IIS FJD, Dept Pathol, Madrid, Spain      Fundacion Jimenez Diaz - Author
Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain.      University of Barcelona    Hospital Clinic de Barcelona - Author
Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain      Hospital Clinic de Barcelona    University of Barcelona - Author
Hosp Mar, Dept Med Oncol, Barcelona, Spain      Hospital del Mar    Institut Hospital del Mar d'Investigacions Mediques (IMIM) - Author
MD Anderson Canc Ctr, Dept Med Oncol, Madrid, Spain      University of Texas System    UTMD Anderson Cancer Center - Author
Mutua de Terrassa Hosp, Dept Med Oncol, Barcelona, Spain      Hospital Universitario Mutua Terrassa       - Author
Quiron Hosp, Dept Med Oncol, Madrid, Spain - Author
Reina Sofia Univ Hosp, Dept Med Oncol, Cordoba, Spain      Hospital Universitario Reina Sofia - Author
Spanish Breast Canc Res Grp, Madrid, Spain - Author
Univ Barcelona, Master Breast Pathol, Barcelona, Spain      University of Barcelona - Author
Univ Complutense, Dept Med Oncol, IISGM, Madrid, Spain.      Complutense University of Madrid - Author
Univ Complutense, Dept Med Oncol, IISGM, Madrid, Spain      Complutense University of Madrid - Author
Vall dHebron Inst Oncol, Barcelona, Spain.      Vall d'Hebron Institut d'Oncologia (VHIO) - Author
Vall dHebron Inst Oncol, Barcelona, Spain      Vall d'Hebron Institut d'Oncologia (VHIO)       - Author
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Abstract

PAM50/Prosigna gene expression-based assay identifies three categorical risk of relapse groups (ROR-low, ROR-intermediate and ROR-high) in post-menopausal patients with estrogen receptor estrogen receptor-positive (ER+)/ HER2-negative (HER2-) early breast cancer. Low risk patients might not need adjuvant chemotherapy since their risk of distant relapse at 10-years is below 10% with endocrine therapy only. In this study, 517 consecutive patients with ER+/HER2- and node-negative disease were evaluated for Ki67 and Prosigna. Most of Luminal A tumors (65.6%) and ROR-low tumors (70.9%) had low Ki67 values (0-10%); however, the percentage of patients with ROR-medium or ROR-high disease within the Ki67 0-10% group was 42.7% (with tumor sizes ?2 cm) and 33.9% (with tumor sizes > 2 cm). Finally, we found that the optimal Ki67 cutoff for identifying Luminal A or ROR-low tumors was 14%. Ki67 as a surrogate biomarker in identifying Prosigna low-risk outcome patients or Luminal A disease in the clinical setting is unreliable. In the absence of a well-validated prognostic gene expression-based assay, the optimal Ki67 cutoff for identifying low-risk outcome patients or Luminal A disease remains at 14%.
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Keywords

assaybreast cancerdistant recurrenceendocrine therapyestrogen receptor-positive/her2-negativeki67pam50/prosignatrialwomenAntineoplastic agents, hormonalBiomarkers, tumorBreast cancerBreast neoplasmsChemotherapy, adjuvantEstrogen receptor-positive/her2-negativeFemaleFollow-up studiesGene expression profilingHumansIncidenceInternational expert consensusKi67Neoplasm recurrence, localPam50/prosignaPrognosisProspective studiesReceptor, erbb-2Receptors, estrogenRisk assessmentTamoxifen

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Oncotarget due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2017, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Oncology.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-17:

  • WoS: 20
  • Scopus: 8
  • Europe PMC: 9
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-17:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 45.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 45 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Italy.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Martinez Florensa, Mario) and Last Author (Martin Andorrà, Margarita).

the authors responsible for correspondence tasks have been Aya Moreno, Francisco, Vidal Losada, Maria Jesús, Prat Aparicio, Aleix and Martin Andorrà, Margarita.

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