Original article / research
Evaluation of Androgen Receptor in Various Molecular Subtypes of Carcinoma Breast and its Relationship with Clinicopathological Parameters: A Retrospective Study
Dr. Vaishali A Walke,
65C, Shri Gajanan Apt. Gajanan Nagar., Nagpur-440015, Maharashtra, India.
Introduction: Endocrine therapies targeting Oestrogen Receptor (ER) are the cornerstone for majority of Breast Cancer (BC) patients. However, 25%-30% of breast tumours that do not express ER are non-responsive to existing endocrine therapies. Study of AR has emerged as a useful marker to refine further the classification of BC subtypes. Anti-androgens therapies are considered to markedly enhance the treatments options and to be the first targeted therapy in hormone-negative BCs.
Aim: To evaluate AR status in various molecular subtypes of BC and to know relation of AR status with Tumour grade, Ki-67 index and Lymph Node (LN) metastasis.
Materials and Methods: This retrospective observational study was carried in tertiary care centre in Government Medical College Nagpur, Maharashtra, India, over a period of two years (from September 2013 to August 2015) and included 40 histopathology proven cases of Infiltrating Duct Carcinoma -No Special Type (IDC-NST) of breast. Tissue Micro Array (TMA) block prepared from all the pooled cases were processed for panel of Immunohistochemical (IHC) markers such as ER, Progesterone Receptor (PR), AR, human epidermal growth factor receptor 2 (Her2/neu) and Ki-67.
Results: The AR expression was observed in 52% (21/40) of BC, independent of ER status. AR expression was 9/25 (36%) in ER negative BC, 75% in Her2 only and 28% in Triple negative group. The Luminal subtype was classified depending on AR status and compared with respect to tumour grade, Ki-67 index and LN status, revealed that AR negative cohort had low tumour grade, lower Ki-67 index and low risk of LN metastasis. Similarly, Triple Negative Breast Carcinoma (TNBC) with AR negative status, when analysed revealed; higher tumour grade and higher mitotic index while LN metastasis was noted in few cases.
Conclusion: The study findings can provide evidence that for ER-negative BCs drugs targeting AR and AR-regulated signalling cascade may be the potential therapies and can emerge as a useful marker for further refinement of BC molecular subtypes particularly in hormone receptor negative BCs.
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