Androgen receptors as a prognostic and predictive factor in breast cancer.

Abstract

Many theoretical and experimental models indicate that androgen receptors can play an important role as prognostic factors in breast cancer. The aim of this study was to evaluate the correlations between the presence of androgen receptors on cancer cells and other selected prognostic and predictive factors with established clinical significance in women with breast cancer after radical surgical treatment. 488 adult females were included in the study, who underwent primary radical surgery for breast cancer. 428 patients (87.7%) had Patey's conservative radical mastectomy and 60 (12.3%) Halsted's radical mastectomy. The mean age at operation was 54.3, ranging from 32 to 79. The mean length of hospitalization was 7.2 days for the patients after Patey's mastectomy and 9.8 days for those after Halsted's mastectomy. The androgen receptor is the most frequently detected steroid receptor on breast cancer cells. Therapeutic efficacy of adjuvant hormone therapy was higher in the group of androgen receptor-positive patients than in androgen receptor-negative ones. The prognosis for androgen receptor-positive patients who underwent adjuvant hormone therapy was better than for those androgen receptor-positive patients who did not receive hormone therapy after primary radical surgery for breast cancer. Assessment of androgen receptor levels on cancer cells should become a routine procedure with patients undergoing primary radical surgery for breast cancer, as it seems to be an important predictive factor.

Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers

“…The role of AR as a prognostic marker has been suggested by other authors, though there is a high variability in patient populations, assay methods, analysis of results, definitions used and reporting of results [3,[10][11][12]23]. Particularly, the IHC cut-off values for positive and negative AR status are quite variable within different studies [3,8] or are not reported at all [12].…”

“…Particularly, the IHC cut-off values for positive and negative AR status are quite variable within different studies [3,8] or are not reported at all [12]. In the present study we used an automated system of analysis of IHC reactions that should avoid the bias of subjectivity linked to quantitative evaluation of IHC markers as performed by traditional microscopy.…”

“…Specific cancer histotypes, such as the apocrine carcinoma consistently express AR [9][10] despite being ER and PgR-negative, and AR expression has been reported in about 45% of triple negative breast cancers [4,8]. Studies using different analytical procedures suc h as a binding assay [11], immunohistochemistry (IHC) [3,12] and reverse-phase protein arrays [13] have suggested a possible role of AR to predict responsiveness to endocrine therapy. The impact of AR expression on survival of patients with high risk ER-positive breast cancer, such as luminal B breast cancer [14][15][16], has never been evaluated.…”

Androgen receptor in breast cancer: expression in estrogen receptor-positive tumors and in estrogen receptor-negative tumors with apocrine differentiation

“…24 One large study of 488 cases from Poland has shown a lower rate (43.4%) of AR expression in breast carcinoma, but this study also reported much lower rates of ER (39.3%) and PR (24.6%) expression. 25 This study also used the same AR antibody clone and dilution as the a Four were luminal A and 4 were luminal B (see Table 2). Five of these eight cases were also negative for PR.…”

Complexities of androgen receptor signalling in breast cancer

“…In cohorts not selected on the basis of estrogen receptor-a (ERa (ESR1)) status, AR positivity has been associated with longer relapse-free, metastasis-free and overall survival, smaller tumour size and lower histological grade (Bryan et al 1984, Langer et al 1990, Kuenen-Boumeester et al 1992, Soreide et al 1992, Schippinger et al 2006, Agrawal et al 2008, Gonzalez et al 2008, Hanley et al 2008, Ogawa et al 2008, Soiland et al 2008, Park et al 2010, Yu et al 2011, Peters et al 2012, Honma et al 2013. High AR levels have also been associated with a favourable response to chemotherapy and hormonal therapy, including antioestrogens, aromatase inhibitors and progestins (Teulings et al 1980, Bryan et al 1984, Birrell et al 1995, Agrawal et al 2008, Chintamani et al 2010, Chanplakorn et al 2011, Loibl et al 2011. Importantly, AR has also been shown to be an independent predictor of relapse-free, metastasis-free and/or overall survival in some studies (Soreide et al 1992, Gonzalez et al 2008, Soiland et al 2008, Yu et al 2011.…”