Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers

<p>Abstract</p> <p>Background</p> <p>Androgen receptors (AR) are frequently expressed in breast cancers, but their implication in cancer growth is still controversial. In the present study, we further investigated the role of the androgen/AR pathway in breast cancer dev...

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Main Authors: Secreto Giorgio, Venturelli Elisabetta, Meneghini Elisabetta, Carcangiu Maria Luisa, Paolini Biagio, Agresti Roberto, Pellitteri Cristina, Berrino Franco, Gion Massimo, Cogliati Patrizia, Saragò Giuseppina, Micheli Andrea
Format: Article
Language:English
Published: BMC 2012-12-01
Series:BMC Cancer
Subjects:
Online Access:http://www.biomedcentral.com/1471-2407/12/599
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author Secreto Giorgio
Venturelli Elisabetta
Meneghini Elisabetta
Carcangiu Maria Luisa
Paolini Biagio
Agresti Roberto
Pellitteri Cristina
Berrino Franco
Gion Massimo
Cogliati Patrizia
Saragò Giuseppina
Micheli Andrea
author_facet Secreto Giorgio
Venturelli Elisabetta
Meneghini Elisabetta
Carcangiu Maria Luisa
Paolini Biagio
Agresti Roberto
Pellitteri Cristina
Berrino Franco
Gion Massimo
Cogliati Patrizia
Saragò Giuseppina
Micheli Andrea
author_sort Secreto Giorgio
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Androgen receptors (AR) are frequently expressed in breast cancers, but their implication in cancer growth is still controversial. In the present study, we further investigated the role of the androgen/AR pathway in breast cancer development.</p> <p>Methods</p> <p>AR expression was evaluated by immunochemistry in a cohort of 528 postmenopausal breast cancer patients previously examined for the association of serum testosterone levels with patient and tumor characteristics. AR expression was classified according to the percentage of stained cells: AR-absent (0%) and AR-poorly (1%-30%), AR-moderately (>30%-60%), and AR-highly (>60%) positive.</p> <p>Results</p> <p>Statistical analysis was performed in 451 patients who experienced natural menopause. AR-high expression was significantly related with low histologic grade and estrogen receptor (ER)- and progesterone receptor (PR)-positive status (<it>P</it> trend<0.001). Mean testosterone levels were significantly higher in the AR-high category than in the other categories combined (<it>P</it>=0.022), although a trend across the AR expression categories was not present. When women defined by ER status were analyzed separately, regression analysis in the ER-positive group showed a significant association of high testosterone levels with AR-highly-positive expression (OR 1.86; 95% CI, 1.10-3.16), but the association was essentially due to patients greater than or equal to 65 years (OR 2.42; 95% CI, 1.22-4.82). In ER-positive group, elevated testosterone levels appeared also associated with AR-absent expression, although the small number of patients in this category limited the appearance of significant effects (OR 1.92; 95% CI, 0.73–5.02): the association was present in both age groups (<65 and ≥65 years). In the ER-negative group, elevated testosterone levels were found associated (borderline significance) with AR-absent expression (OR 2.82, 95% CI, 0.98-8.06). In this ER-negative/AR-absent subset of tumors, elevated testosterone levels cannot stimulate cancer growth either directly or after conversion into estrogens, but they probably induce increased synthesis of some other substance that is responsible for cancer growth through binding to its specific receptor.</p> <p>Conclusions</p> <p>The findings in the present study confirm that testosterone levels are a marker of hormone-dependent breast cancer and suggest that the contemporary evaluation of ER status, AR expression, and circulating testosterone levels may identify different subsets of cancers whose growth may be influenced by androgens.</p>
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spelling doaj.art-06452c6202a44cedb9c158a6c72225bf2022-12-21T20:46:45ZengBMCBMC Cancer1471-24072012-12-0112159910.1186/1471-2407-12-599Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancersSecreto GiorgioVenturelli ElisabettaMeneghini ElisabettaCarcangiu Maria LuisaPaolini BiagioAgresti RobertoPellitteri CristinaBerrino FrancoGion MassimoCogliati PatriziaSaragò GiuseppinaMicheli Andrea<p>Abstract</p> <p>Background</p> <p>Androgen receptors (AR) are frequently expressed in breast cancers, but their implication in cancer growth is still controversial. In the present study, we further investigated the role of the androgen/AR pathway in breast cancer development.</p> <p>Methods</p> <p>AR expression was evaluated by immunochemistry in a cohort of 528 postmenopausal breast cancer patients previously examined for the association of serum testosterone levels with patient and tumor characteristics. AR expression was classified according to the percentage of stained cells: AR-absent (0%) and AR-poorly (1%-30%), AR-moderately (>30%-60%), and AR-highly (>60%) positive.</p> <p>Results</p> <p>Statistical analysis was performed in 451 patients who experienced natural menopause. AR-high expression was significantly related with low histologic grade and estrogen receptor (ER)- and progesterone receptor (PR)-positive status (<it>P</it> trend<0.001). Mean testosterone levels were significantly higher in the AR-high category than in the other categories combined (<it>P</it>=0.022), although a trend across the AR expression categories was not present. When women defined by ER status were analyzed separately, regression analysis in the ER-positive group showed a significant association of high testosterone levels with AR-highly-positive expression (OR 1.86; 95% CI, 1.10-3.16), but the association was essentially due to patients greater than or equal to 65 years (OR 2.42; 95% CI, 1.22-4.82). In ER-positive group, elevated testosterone levels appeared also associated with AR-absent expression, although the small number of patients in this category limited the appearance of significant effects (OR 1.92; 95% CI, 0.73–5.02): the association was present in both age groups (<65 and ≥65 years). In the ER-negative group, elevated testosterone levels were found associated (borderline significance) with AR-absent expression (OR 2.82, 95% CI, 0.98-8.06). In this ER-negative/AR-absent subset of tumors, elevated testosterone levels cannot stimulate cancer growth either directly or after conversion into estrogens, but they probably induce increased synthesis of some other substance that is responsible for cancer growth through binding to its specific receptor.</p> <p>Conclusions</p> <p>The findings in the present study confirm that testosterone levels are a marker of hormone-dependent breast cancer and suggest that the contemporary evaluation of ER status, AR expression, and circulating testosterone levels may identify different subsets of cancers whose growth may be influenced by androgens.</p>http://www.biomedcentral.com/1471-2407/12/599Androgen receptorsAndrogensPostmenopausal breast cancerTestosterone levels
spellingShingle Secreto Giorgio
Venturelli Elisabetta
Meneghini Elisabetta
Carcangiu Maria Luisa
Paolini Biagio
Agresti Roberto
Pellitteri Cristina
Berrino Franco
Gion Massimo
Cogliati Patrizia
Saragò Giuseppina
Micheli Andrea
Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
BMC Cancer
Androgen receptors
Androgens
Postmenopausal breast cancer
Testosterone levels
title Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
title_full Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
title_fullStr Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
title_full_unstemmed Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
title_short Androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
title_sort androgen receptors and serum testosterone levels identify different subsets of postmenopausal breast cancers
topic Androgen receptors
Androgens
Postmenopausal breast cancer
Testosterone levels
url http://www.biomedcentral.com/1471-2407/12/599
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