Core Needle Biopsy Accuracy for Androgen Receptor Expression in Invasive Breast Cancer

Objective Breast cancer (BC) biomarkers, such as hormone receptors expression, are crucial to guide therapy in BC patients. Antiandrogens have been studied in BC; however, limited data are available on androgen receptor (AR) expression test methodology. We aim to report the core needle biopsy (CNB)...

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Published in:	Revista Brasileira de ginecologia e obstetrícia Vol. 45; no. 9; pp. e535 - e541
Main Authors:	Santos, Marcelle Morais dos, Frasson, Antonio Luiz, Silva, Vinicius Duval da, Maciel, Aluísio de Castro Antunes, Watte, Guilherme, Werutsky, Gustavo, Reinert, Tomás, Fay, André Poisl
Format:	Journal Article
Language:	English
Published:	Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01-09-2023 Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Subjects:	androgen receptor biomarkers breast cancer core needle biopsy immunohistochemistry OBSTETRICS & GYNECOLOGY Original \| Artigo Original biópsia com agulha de grande calibre androgen receptor câncer de mama receptores androgênicos biomarkers breast cancer immunohistochemistry core needle biopsy biomarcadores imuno-histoquímica
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Summary:	Objective Breast cancer (BC) biomarkers, such as hormone receptors expression, are crucial to guide therapy in BC patients. Antiandrogens have been studied in BC; however, limited data are available on androgen receptor (AR) expression test methodology. We aim to report the core needle biopsy (CNB) accuracy for AR expression in BC. Methods Patients diagnosed with stage I-III invasive BC from a single institution were included. Androgen receptor expression was evaluated by immunohistochemistry (IHC) using 1 and 10% cutoff and the AR expression in surgical specimens (SS) was the gold standard. Kappa coefficients were used to evaluate the intraprocedural agreement. Results A total of 72 patients were included, with a mean age of 61 years old and 84% were Luminal A or B tumors. The prevalence of AR expression in all BC samples was 87.5% using a cutoff ≥ 10% in SS. With a cutoff value ≥ 1%, CNB had an accuracy of 95.8% (Kappa value = 0.645; 95% confidence interval [CI]: 0.272–1.000; p < 0.001) and 86.1% (Kappa value = 0.365; 95% CI: 0.052–0.679; p < 0.001) when ≥ 10% cutoff was used for AR positivity. Androgen receptor expression in CNB (cutoff ≥ 1%) had a sensitivity of 98.5%, specificity of 60%, positive predictive value of 97.0%, and a negative predictive value of 76.9% in the detection of AR expression in SS. Conclusion Core needle biopsy has good accuracy in evaluating AR expression in BC. The accuracy of CNB decreases with higher cutoff values for AR positivity.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0100-7203 1806-9339 1806-9339
DOI:	10.1055/s-0043-1772486