Androgen receptor expression in a Sri Lankan patient cohort with early breast carcinoma

Autor: Sanjeev Vigneshwara, J. Fernando, Dehan Gunasekera, Menaka Dilani Samarawickrama Lokuhetty, Zahara Mansoor, G. K. Wijesinghe, H. D. Wijesinghe
Rok vydání: 2020
Předmět:
Adult
Oncology
medicine.medical_specialty
Receptor
ErbB-2
Breast carcinoma
Breast Neoplasms
lcsh:Gynecology and obstetrics
Androgen receptors
Disease-Free Survival
03 medical and health sciences
0302 clinical medicine
Internal medicine
Progesterone receptor
Biomarkers
Tumor
Prevalence
Adjuvant therapy
Humans
Medicine
lcsh:RG1-991
Mastectomy
Aged
Sri Lanka
030304 developmental biology
0303 health sciences
Univariate analysis
business.industry
Proportional hazards model
lcsh:Public aspects of medicine
Obstetrics and Gynecology
lcsh:RA1-1270
General Medicine
Middle Aged
Ductal carcinoma
Prognosis
Immunohistochemistry
Receptors
Estrogen
Reproductive Medicine
Receptors
Androgen
030220 oncology & carcinogenesis
Androgens
Female
Triple-Negative Breast Carcinoma
Receptors
Progesterone
business
Clinicopathological features
Research Article
Zdroj: BMC Women's Health
BMC Women's Health, Vol 20, Iss 1, Pp 1-14 (2020)
ISSN: 1472-6874
DOI: 10.1186/s12905-020-01068-5
Popis: Background Androgen receptor (AR) expression is emerging as a prognostic biomarker in breast carcinoma (BCa). The study aimed to determine the prevalence of AR expression by immunohistochemical analysis among a cohort of Sri Lankan women with early BCa and to evaluate its association with clinicopathological features including immunohistochemical molecular subtype and early survival. Method We studied the clinical and pathological features and immunohistochemical profile of 141 women undergoing primary surgery for early BCa, followed by standard adjuvant therapy. AR status was assessed by immunohistochemistry in all cases. Overall survival (OS) and disease-free survival (DFS) was determined. The relationship between AR expression and clinical and pathological parameters and immunohistochemical molecular subtype was analyzed using Student T test and chi-square tests. Cox regression analysis was used to analyze the prognostic impact of AR expression. Results AR expression was seen in 40.8%(95%CI 33.10–49.07%) of the BCa study cohort. None of the clinical data studied showed a significant association with the AR status(p > 0.05). Ductal carcinoma in situ(p = 0.003), oestrogen receptor (ER) (p = 0.001) and progesterone receptor (PR) (p = 0.001) positivity and luminal IHC molecular subtype(p = 0.016) were significantly associated with AR-positive status. AR-negative status was significantly associated with tumour necrosis > 50%(p = 0.031), moderate to extensive lymphocytic infiltrate at the tumour margin(p = 0.025) and basal triple negative breast carcinoma(p = 0.016). The mean duration of patient follow-up was 46.70(95% CI 46.495–46.905) months (3.89 years). On univariate analysis, AR-positivity was associated with better OS among ER-positive tumours(p = 0.047), specifically in postmenopausal women (p = 0.030). In ER-negative tumours, AR positivity was associated with worse DFS (p = 0.036). On multivariate analysis, TNM stage and ER/AR status were predictive of survival. ER-positive/AR-positive (ER+/AR+) tumours demonstrated better OS than ER-positive/AR-negative (ER+/AR-) tumours(p = 0.015). ER-negative/AR-positive (ER−/AR+) tumours (p = 0.014) had a worse DFS than ER-negative/AR-negative (ER−/AR-) tumours. Conclusions AR prevalence obtained was low. AR positivity was associated with positivity for ER and PR. On multivariate analysis, apart from TNM stage only ER/AR status were predictive of OS and DFS, with concordant expression of ER/AR demonstrating a better, early survival.
Databáze: OpenAIRE
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