engleski

Clinical value of androgen receptors in triple negative breast cancer

Today, there is still no clear and unambiguous view on the role of androgen receptors (AR) in breast cancer, nor in triple-negative breast cancer (TNBC). A series of studies over the years have shown very heterogeneous results. Given the lack of a valid biomarker in TNBC, much hope is placed in the prognos- tic and predictive potential of AR in this aggressive disease. We performed a retrospective cohort study on the consecutive sample of 151 early TNBC patients diagnosed and treated at the University Hospital for Tumors in 2009-2012. We analyzed AR using immunohistochemistry (IHC), with the cutoff value for posi- tivity of ≥1%, referring to current ASCO/CAP recommendations on hormone receptor (ER and PR) analy- sis. The analysis was adjusted for age, comorbidities, menopausal status, histological type of tumor, tumor size, number of positive lymph nodes, stage of disease, Ki-67 proliferation index, type of surgery of the breast and axilla, and treatment with adjuvant chemotherapy and radiotherapy. Correlations of AR with all parameters were calculated, as well as 5 - year disease – free survival (DFS) and overall survival (OS). Incidence of AR (≥1%) in patients with early TNBC in our analysis was 31.1%, of which 85% of patients had AR≥10% and as many as 60% had AR>50%. AR were found to be statistically significantly positively cor- related with age and menopausal status, and statistically significantly negatively correlated with tumor size, grade and Ki67, as well as disease stage. AR≥1% showed no statistically significant association with DFS, median DFS was not reached for both groups of patients, those with AR≥1% as well as those without AR, with HR for disease recurrence or death of 1.08. AR were not statistically significantly associated with OS, there was no difference in the 5-year OS of patients with AR≥1%, compared with those with AR <1%, and median OS was not reached in either group. In this analysis, AR proved to be significantly correlated to more indolent, favorable disease characteristics, as expected and seen in many other analyses. However, AR did not prove to be an independent factor in the prognosis of patients with early TNBC in this cohort. Taking into consideration that there have been some of the larger studies confirming the role of AR as a good prognostic factor in this population of patients (although still with many controversies), further analyses should consider larger sample size, but also additional molecular markers in TNBC that might be in the background of forming the ultimate disease behaviour.

triple-negative breast cancer, androgen receptors, biomarker, prognostic biomarker

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