Prognostic Relevance of Androgen Receptor Detection in Operable Breast Cancer

Background and objectives: Androgen receptor (AR) is relevant for prognostication in breast cancer. Different determination methods and Cutoff levels hamper interpretation and comparisons of studies. Long-term prognostic evaluation of different AR assays in patients comprising operable breast cancers is scarce. Methods: AR wits evaluated in 120 primary tumors using the dextran-coated charcoal method (charc-AR), and quantitative immunohistochemistry (IHC) on whole sections (WS) and tissue microarrays (TMA). Nuclear and cytoplasmic-AR localization wits determined, and the prognostic importance of AR assays was assessed. Comparisons and correlations with the mitotic activity index (MAT), estrogen receptor (ER alpha), progesterone receptor (PR), HER-2, and histological grade (WHO I-III) were made. Results: Nuclear-AR in WS, but not charc-AR, strongly correlated with MAI (P=0.001). However, prognostic information appeared in Univariate Survival analyses only. Nuclear-AR in TMA was not prognostic. Charc-AR was independent prognostic in node positives both for relapse free survival (RFS) and breast cancer specific Survival (BCSS). Both charc-AR and IHC cytoplasmic-AR provided independent prognostic survival information for BCSS in women <55 years. Conclusion: Methods that can delect AR localized in the cytoplasm yield important prognostic information, and further Studies in patients with operable breast. cancer are warranted.