Prevalence of Androgen Receptors Expression in Triple Negative Breast Cancer Patients and its Correlation with Clinicopathological Criteria: Our Institutes Experience

Background: Triple negative breast cancer (TNBC) is a term that has been applied to breast cancers which lack expression of three receptors: estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor receptor 2 (HER2). It represents about 20% of breast cancers diagnosed worldwide. TNBC is a challenging type by its presentation criteria and limited options of treatment. Continuous research for finding specific target is the aim of scientists. Androgen receptors (AR) expression take special attention in this type of breast cancer as its expression can help for finding special targeted treatment as anti-androgen therapy.
Purpose: To assess the AR expression in TNBC patients and to correlate its expression with clinicopathological parameters and disease outcome of patients in study populations.
Methods: This prospective study included 90 female patients confirmed as TNBC patients in medical oncology and clinical oncology departments, in Mansoura University and Zagazig University, Egypt, from December 2013 to May 2016. AR positive expression was defined as ≥10% nuclear immunostaining.
Results: AR expression was positive in twenty seven (27/90) patients (30%), and lack of its expression was significantly associated with younger age group (p < 0.001), higher grade (p = 0.017) & higher tumor stage (p < 0.001), presence of lymph node metastasis (p < 0.001) & distant metastases (p = 0.032), vascular (p = 0.044) & perineural invasion and high baseline CA 15-3 level (p < 0.001). Median follow up duration was 17.5 months (range 6-40), 32/90 died (35.6%). Mean overall survival (OS) was 28 months for AR negative TNBC patients versus 32 months for AR positive patients. Twenty four of died patients (24/32) were AR negative. Three years OS was 50.8% and 44.1% for AR positive and AR negative respectively, but with non-significant P-value.
Conclusions: Our study confirmed that AR positive expression in TNBC is a good prognostic feature and it can be sued as target for anti-androgen therapy in this group who are lacking any target treatment.