There were no associations of changes in the ER, HER2 status with distant disease-free survival (DDFS) after surgical resection of IBTR, whereas the change in the Ki-67 status between the primary tumors and IBTR was significantly correlated with DDFS (unadjusted:p ¼ 0.0094; adjusted: p ¼ 0.013). Patients in the “increased or remained high” Ki-67 group had a significantly shorter DDFS than those in the “decreased or remained low” Ki-67 group (5-year DDFS: 55.5 vs. 79.3%, espectively, p ¼ 0.0084 by log-rank test).