A Cross-sectional Study; Investigation of Prevalence and Prognostic Importance of Androgen Receptor Expression in Triple Negative Breast Cancer
Project no. 20123 · Status: Kapanmış (Yayın bekleniyor) · 2018
Summary
INTRODUCTION: Breast cancer is the most common type of cancer in women, but also the second most common cause of death after lung cancer. While the classification of malignant breast tumors has traditionally been done according to histological appearance, it is now divided into subtypes according to its molecular characteristics. Since there is no expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER-2), the group called triple negative accounts for 10-20% of all breast cancers. Triple negative breast cancer (TNBC) is more aggressive than other breast cancer types, high recurrence rate and short survival time are evident in this group. There is no targeted treatment option at TNBC, so it can only be treated with chemotherapy today. Since ER and PR are not present in patients with TNBC, AR positivity may be important in terms of prognosis and treatment options in this group. Although the prognostic and predictive role of ER and PR in breast cancer is well known, the prognostic value of AR, which is frequently expressed in both normal breast tissue and primary tumors, is not yet fully understood. METHODS: The study included patients with a history of triple negative breast cancer diagnosed older than 18 years, who were followed-up and treated at Ege University Medical Faculty Hospital between 2005 and 2017. Prevalence of androgen receptor (AR) expression, Ki67 proliferation index, histological types, nuclear and histological grades, development of recurrence, presence of metastasis at follow-up, and presence of metastasis were compared comparatively in all cases. RESULTS: 100 TNBC cases were included in the study. The ages of the patients ranged between 51.45 ± 11.39 and body mass index (BMI) ranged between 28.55 ± 5.66. The minimum age was 18 and the maximum age was 75, while the minimum BMI was 16.40 and the maximum BMI was 54.20. 84% of the patients had no family history, while 11% had a family history. Tumor diameters were between 3.05 ± 1.74 mm. 60% (60 patients) had no lymph node involvement, 40% (40 patients) had lymph node involvement. AR expression was detected in 36 patients (36%), whereas no expression was observed in 64 patients (64%). 33.3% (n = 12) of our cases were strongly positive with AR; 66.6% (n = 24) showed weak-moderate strength positivity. Four of the patients had apocrine histological type, all of which expressed strong AR. Recurrence was detected in 2 (9.5%) of 21 patients with negative lymph node and AR +, and 12 (30%) of 39 patients with negative lymph node and AR-. 10 (27.7%) of 36 patients with AR + and 24 (37.5%) of 64 patients with AR- were lost during follow-up. In our study, although there was no statistically significant relationship between overall survival and disease-free survival and AR status, in early stage TNBC patients both disease-free survival was significantly longer in the AR-positive group. No significant difference was found between AR positive / negative group in locally advanced patients. CONCLUSION: Although there was no statistically significant relationship between AR expression and clinicopathological parameters and survival in TNBC cases, larger series of studies were needed in this study. Furthermore, with the inclusion of AR in routine histopathological examination in the TNBC group with an expression rate of 36%, it was thought that future AR-targeted therapies may be a glimmer of hope.