Androgen Receptors Expression in Patients With Triple-negative Breast Cancer. Bivariate Correlation and Prevalence Study.
Authors: Enríquez-Brena Sandra Zynzya , Ramírez-Balderrama Lázaro , García-Mendoza Yunuén Ibiza , Mendoza-Ramírez Saulo , Hernández-González Martha Alicia , Murillo-Ortiz Blanca , Olvera-Olvera Marco Antonio , Murguia-Perez Mario 
Published: May 2021

Abstract
BACKGROUND. Breast cancer is a pathology with repercussions on public health, which is histologically classified into 2 large groups, ductal and lobular; Although there is no variability in the treatment therapy based on these characteristics, with the help of special immunohistochemical techniques it is subclassified according to the molecular classification recognized by the WHO into 5 categories, including triple-negative breast cancer, which presents a worse prognosis than that of the rest of the groups. Some of these groups are those with low expression of claudins, and others with apocrine differentiation that may have reactivity to Her2/neu or be properly triple negative. In these, adjuvant therapy is only with chemotherapy. In the subgroup of apocrine type tumors, when studying androgen receptors it was noted that they have an important role in tumorigenesis and that there may be an expression in part of triple-negative tumors, creating a therapeutic target that can benefit these patients, with benefit in clinical trials that have been conducted.METHODS. This study is an ambilective, descriptive, cross-sectional study that includes paraffin embedded tissue samples in triple-negative breast malignant tumors of patients detected in in the database of the Department of Surgical Pathology of High Specialty Medical Unit No. 1 Bajío who meet inclusion criteria. Immunohistochemistry technique was performed by manual method in three steps, using monoclonal antibody against androgen receptors (androgen receptor, Zeta Diagnostic brand, EP120 clone), and evaluated by peer review made on a Leica DM1000 light microscope. The histological variables were reviewed and the positivity or negativity of androgen receptors and their percentage of expression were assessed, replicating the H-Score system. Also, the correlation of androgen receptor expression with histological variables was performed. RESULTS. Of 76 cases that met the inclusion criteria, 18.42% had androgen receptors by immunohistochemistry. This means that about 2 out of every 10 patients with triple-negative breast cancer have tumors with presence of androgen receptors; In the cases that presented them, a search was carried out for correlations between the morphological histological variables and concerning the presence of these receptors, without finding significant associations and we corroborated that their presence is independent of the morphology, as previously described in the literature.CONCLUSIONS. In triple-negative cases, the existence or not of androgen receptors can be added to suggest offering target treatment, blocking them. Our results propose that the systematization in the search for androgen receptors in triple-negative breast cancer offers the possibility of targeted therapy. Equally important is having been able to corroborate that the presence of androgen receptors is an independent parameter to tumor histological types.