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The prognostic value of androgen receptors in breast cancer subtypes

  • Preclinical study
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Abstract

Purpose

Androgen receptor (AR) expression is frequent in breast cancer and has been associated with good prognosis in several studies. The present study investigates AR-expression in relation to molecular subtypes, clinicopathological features and prognosis in 1297 primary tumours and 336 paired axillary lymph node metastases (LNM) from two cohorts of Norwegian patients.

Methods

Immunohistochemistry for AR was performed on tumours previously reclassified into molecular subtypes using immunohistochemistry and in situ hybridisation. Associations between AR-expression and clinical features were studied using Chi-square tests. Cumulative incidence of breast cancer death and Cox regression analyses were used to assess prognosis.

Results

AR-positivity was found in 78.0% of all cases, 84.9% of luminal and 45.1% of non-luminal tumours. The highest proportion of AR-positivity was found in Luminal B tumours, and the lowest in the Basal phenotype. Discordance in AR-status between primary tumours and lymph node metastases was observed in 21.4% of cases. A switch from AR− primary tumour to AR+ lymph node metastasis was seen in 60/72 discrepant cases. AR-expression in primary tumours was an independent and favourable prognostic marker (HR 0.70, 95% CI 0.55–0.90), particularly in the Luminal A subtype, and in grade 3 tumours.

Conclusions

AR is an independent predictor of good prognosis in BC, particularly in grade 3 and Luminal A tumours. Discordant AR-expression between primary tumour and LNM was observed in 21.4% of cases and most often there was a switch from AR− primary tumour to AR+ axillary LNM.

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Fig. 1
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Adapted from Breast Cancer Res Treat, 2013, Vol 140, Engstrøm et al, Molecular subtypes, histopathological grade and survival in a historic cohort of breast cancer patients [17] Fig. 2, p 466. Open access, permission for reprint not required

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Data availability

The datasets generated and/or analysed in the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the Department of Pathology, St. Olav’s University Hospital, Trondheim, Norway, for making the archives available for the study, the Cancer Registry of Norway for providing the patient data, and senior biomedical engineer Borgny Ytterhus and biomedical engineer Anette Hansen Skjervold MSc, NTNU for excellent technical assistance.

Funding

Funding was provided by the Liaison Committee for Education, Research and Innovation in Central Norway, The Central Norway Health Authority (Project Number: 46030001).

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Authors and Affiliations

  1. Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Maria Ryssdal Kraby, Marit Valla, Signe Opdahl, Olav Anton Haugen & Anna Mary Bofin

  2. Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway

    Marit Valla, Signe Opdahl & Monica Jernberg Engstrøm

  3. Department of Clinical Pharmacology, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway

    Joanna Ewa Sawicka

  4. Department of Breast and Endocrine Surgery, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway

    Monica Jernberg Engstrøm

  5. Department of Clinical and Molecular Medicine, The Laboratory Centre, Norwegian University of Science and Technology, Erling Skjalgssons gate 1, 7030, Trondheim, Norway

    Anna Mary Bofin

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  1. Maria Ryssdal Kraby
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  2. Marit Valla
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Correspondence to Anna Mary Bofin.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval for this study, including dispensation from the requirement of patient consent, was granted by the Regional Committee for Medical and Health Sciences Research Ethics (REK, Midt-Norge, Ref. nr: 836/2009).

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Kraby, M.R., Valla, M., Opdahl, S. et al. The prognostic value of androgen receptors in breast cancer subtypes. Breast Cancer Res Treat 172, 283–296 (2018). https://doi.org/10.1007/s10549-018-4904-x

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