MKI67 and metastatic malignant neoplasm in the lymph nodes: In Tsunoda et al. case series of 13 EPC patients the Ki-67 index was 16.6% in patients with no lymph node metastases, 21.0% in patients with positive sentinel lymph nodes and, 32.3% in patients with clinical and/or revealed by imaging lymph node metastases at presentation [22].