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Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers

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Abstract

The purpose of this article is to evaluate the prognostic value of androgen receptor (AR) expression in patients with estrogen receptor (ER)-positive breast cancer, treated with endocrine therapy, with or without the addition of chemotherapy. A consecutive series of 953 patients with ER-positive breast cancer, treated between 1998 and 2003, was selected. Repeated immunohistochemistry confirmed the expression of ER in the tumor of 938 patients. AR expression was measured by immunohistochemistry. The Kaplan–Meier method, logrank test and multivariate Cox models were used to explore the impact of AR expression on time to relapse (TTR) and disease specific survival (DSS) in all patients and in subgroups treated with chemo-endocrine therapy or endocrine therapy alone. AR immunoreactivity was assessable in 859 tumors and positive in 609 (70.9%). AR expression was a significant marker of good prognosis for TTR (P = 0.001) and DSS (P < 0.001). This effect was particularly evident in the group of patients receiving chemo-endocrine therapy (TTR (P = 0.015) and DSS (P < 0.001)). Cox models confirmed AR as an independent variable for both TTR (P = 0.003, HR 0.444, 95%CI 0.258–0.765) and DSS (P < 0.001, HR 0.135, 95%CI 0.054–0.337). Thus, we focused on ER-positive luminal B breast cancer that may be selected for chemotherapy because of their more aggressive immunophenotype. In this subset AR expression identified a group of patients with better prognosis for TTR (P = 0.017, HR 0.521, 95%CI 0.306–0.888) and DSS (P = 0.001, HR 0.276, 95% CI 0.130–0.588). AR expression is an independent prognostic factor of better outcome in patients with ER-positive breast cancers.

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Acknowledgments

This study was funded by Compagnia San Paolo di Torino, Cassa di Risparmio di Torino, AIRC 2007–2009, Ricerca Finalizzata Regione Piemonte 2008, MIUR-PRIN 2008.

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Authors and Affiliations

  1. Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126, Turin, Italy

    Isabella Castellano, Elena Allia, Luigi Chiusa, Gianni Bussolati & Anna Sapino

  2. Department of Obstetrics and Gynaecology, Sant’Anna Hospital, Turin, Italy

    Valeria Accortanzo & Antonio Durando

  3. Centro Oncologico Subalpino (COES), Molinette Hospital, Turin, Italy

    Anna Maria Vandone & Michela Donadio

  4. Department of Pathology, Sant’Anna Hospital, Turin, Italy

    Riccardo Arisio

  5. International Breast Cancer Study Group, Bern, Switzerland

    Alan S. Coates

  6. School of Public Health, University of Sydney, Sydney, Australia

    Alan S. Coates

  7. Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy

    Giuseppe Viale

Authors
  1. Isabella Castellano
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  2. Elena Allia
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  3. Valeria Accortanzo
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  4. Anna Maria Vandone
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  5. Luigi Chiusa
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  6. Riccardo Arisio
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  7. Antonio Durando
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  8. Michela Donadio
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  9. Gianni Bussolati
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  10. Alan S. Coates
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  11. Giuseppe Viale
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  12. Anna Sapino
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Corresponding author

Correspondence to Anna Sapino.

Additional information

An invited commentary to this article can be found at doi:10.1007/s10549-010-0864-5.

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Castellano, I., Allia, E., Accortanzo, V. et al. Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers. Breast Cancer Res Treat 124, 607–617 (2010). https://doi.org/10.1007/s10549-010-0761-y

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  • DOI: https://doi.org/10.1007/s10549-010-0761-y

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