Androgen receptor expression in triple-negative breast cancer: A retrospective cross-sectional study from South India

Prognostic significance of androgen receptor expression in breast cancer patients undergoing neoadjuvant chemotherapy

The androgen receptor (AR) is an emerging biomarker in breast cancer (BC), yet its prognostic relevance in patients undergoing neoadjuvant chemotherapy (NACT) remains inconclusive. While most studies focus on Western populations, data from the Caucasus are scarce. Given regional differences in tumor biology and treatment access, evaluating AR’s clinical significance in these populations is crucial. This study aimed to investigate the association between AR expression, pathological response, and disease-free survival (DFS) in stage II to III BC patients receiving NACT. A retrospective cohort study was conducted on 132 female BC patients treated with NACT at Bonadea Hospital. AR expression patterns were categorized as negative, weak, moderate, or strong. Statistical analyses included chi-square tests, Kaplan–Meier survival analysis, and univariate Cox regression to evaluate associations between AR expression and clinicopathological features, pathological complete response (pCR), and DFS. The median age at diagnosis was 47 years. Invasive ductal carcinoma accounted for 91.1% of cases, with 50.0% of tumors graded as II or III. pCR was achieved in 28.6% of patients. Moderate-to-strong AR expression was observed in 15% of cases and was associated with a significantly lower Ki-67 index (P = .047). Although dichotomized AR expression did not significantly predict DFS (hazard ratio [HR]: 0.35, 95% confidence interval [CI]: 0.08–1.47, P = .151), Cox regression using all 4 AR categories revealed a significant reduction in recurrence risk (HR = 0.384, 95% CI: 0.160–0.918, P = .031). In multivariable model adjusting for estrogen receptor, human epidermal growth factor receptor 2, and Ki-67 expression, moderate-to-strong AR expression remained the most influential prognostic factor, although the association did not reach statistical significance (adjusted HR: 0.31, 95% CI: 0.07–1.41, P = .129; concordance index = 0.83). Among patients with residual disease (non-pCR), moderate-to-strong AR expression was associated with a higher 2-year DFS rate (90.9% vs 46.4%, P = .089). Sensitivity analysis demonstrated no evidence of selection bias related to AR data availability, as 2-year DFS was comparable between patients with and without available AR assessment (76.1% vs 71.6%, log-rank P = .975). Moderate-to-strong AR expression may be associated with improved DFS in patients treated with NACT, especially in those with incomplete pathological response. These findings highlight the potential of AR as a prognostic biomarker and therapeutic target, warranting validation in prospective studies.

Association of CK5/6 Expression with Five-Year Mortality Rate in Triple-Negative Breast Cancer

Background: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with limited treatment options and variable clinical outcomes. Cytokeratin 5/6 (CK5/6) has been proposed as a potential prognostic marker in TNBC. Objectives: This study aimed to evaluate CK5/6 expression and its association with clinicopathological characteristics and five-year mortality in patients with TNBC. Methods: This retrospective longitudinal study included 50 patients with TNBC who were diagnosed between 2011 and 2016 at Shahid Sadoughi Hospital, Yazd, Iran. CK5/6 expression was assessed by immunohistochemistry using formalin-fixed, paraffin-embedded tissue samples. Clinicopathological variables and five-year mortality were analyzed. Univariate and multivariate logistic regression analyses were performed to identify factors associated with five-year mortality. Results: Among the 50 patients, 45 (90%) exhibited positive CK5/6 expression. Five-year mortality occurred in 10 (20%) patients. CK5/6 expression was significantly associated with five-year mortality (P = 0.01). In univariate analysis, tumor stage (OR = 10.4, 95% CI, 2.40 - 45.08; P < 0.01) and CK5/6 expression (OR = 0.12, 95% CI, 0.01 - 0.87; P = 0.03) were significantly associated with mortality. In multivariate analysis, age (OR = 1.12, 95% CI, 1.01 - 1.23; P = 0.02), tumor stage (OR = 6.36, 95% CI, 1.49 - 27.07; P = 0.01), and CK5/6 expression (OR = 0.04, 95% CI, 0.002 - 0.65; P = 0.02) remained significantly associated with five-year mortality. No significant associations were observed for lymph node involvement, tumor grade, or the CK5/6 staining index. Conclusions: CK5/6 expression was associated with five-year mortality in patients with TNBC and may have prognostic value when evaluated alongside clinicopathological factors. Larger studies are needed to further assess the prognostic role of CK5/6 in TNBC.

Clinicopathological relevance of Ki-67 expression and its association with immunoprofile in breast cancer

Background: Ki-67 is a widely used proliferation marker in breast carcinoma; however, its prognostic relevance remains inconsistent due to variability in assessment and lack of standardized cut-offs. Its correlation with established clinicopathological parameters and hormone receptor status continues to be an area of active investigation. Objectives were to evaluate Ki-67 expression and determine its association with clinicopathological features and immunohistochemical markers (ER, PR, HER2/neu) in invasive breast carcinoma. Methods: This hospital-based cross-sectional study included 88 cases of primary invasive breast carcinoma. Ki-67 expression was assessed by immunohistochemistry and categorized as low (<20%) or high (≥20%). Associations with tumor size, grade, lymph node status, lymphovascular invasion, perineural invasion, and hormone receptor status were analyzed using Chi-square/Fisher’s exact test. A p<0.05 was considered statistically significant. Results: High Ki-67 expression (≥20%) was observed in 44.3% of cases. Significant associations were noted between high Ki-67 expression and larger tumor size (p=0.018), higher histological grade (p=0.013), lymphovascular invasion (p=0.001), perineural invasion (p=0.002), and HER2/neu positivity (p=0.001). No significant association was found with age, lymph node metastasis, ER status, PR status, combined ER/PR status, or triple marker status. Conclusions: Ki-67 expression demonstrates significant association with adverse pathological features and HER2/neu positivity, supporting its role as an adjunct prognostic marker in invasive breast carcinoma. Incorporation of Ki-67 into routine evaluation may enhance risk stratification, particularly in resource-limited settings; however, standardization of assessment methods remains essential for its optimal clinical utility.  

IMMUNOHISTOCHEMICAL EXPRESSION OF CXCR2 IN BREAST CARCINOMA AND ITS ASSOCIATION WITH ER, PR AND HER2/NEU STATUS: A CROSS-SECTIONAL STUDY FROM A TERTIARY CARE CENTRE

Background:CXC chemokine receptor-2 (CXCR2) has emerged as a candidate cancer stem-cell related biomarker in breast carcinoma, with reported roles in epithelial–mesenchymal transition, angiogenesis, metastasis and chemoresistance. However, clinicopathological data on CXCR2 expression in routine breast carcinoma specimens remain limited. The present study evaluated CXCR2 immunohistochemical expression in breast carcinoma and assessed its association with estrogen receptor (ER), progesterone receptor (PR), HER2/neu status and clinicopathological parameters.Methods:This cross-sectional analytical study was carried out in the Department of Pathology, Era’s Lucknow Medical College and Hospital, Lucknow, India, over 20 months (April 2020 to November 2021). Fifty newly diagnosed, histopathologically confirmed cases of breast carcinoma were included. Formalin-fixed paraffin-embedded sections were stained with hematoxylin and eosin for diagnosis and grading. Immunohistochemistry was performed for ER, PR, HER2/neu and CXCR2. ER and PR were interpreted as positive or negative; HER2/neu was interpreted according to standard immunohistochemical criteria; CXCR2 immunoreactivity was categorized as low expression (score <6) or high expression (score ≥6). Associations with age, AJCC clinical stage and Nottingham histological grade were analyzed using chi-square testing.Results:Of the 50 patients, 24 (48.0%) were aged <45 years and 26 (52.0%) were aged ≥45 years. Clinical stage II was the most common stage (32/50, 64.0%), and Nottingham grade II was the predominant histological grade (23/50, 46.0%). ER positivity, PR positivity and HER2/neu positivity were observed in 17 (34.0%), 12 (24.0%) and 13 (26.0%) cases, respectively. High CXCR2 expression was identified in 29 (58.0%) cases, while 21 (42.0%) showed low expression. High CXCR2 expression was significantly associated with age ≥45 years (76.9% vs 37.5% in patients <45 years; χ²=7.9, p=0.004) and higher Nottingham grade (grade I: 12.5%, grade II: 73.9%, grade III: 81.8%; χ²=18.25, p=0.0001). CXCR2 expression increased with advancing clinical stage, but the association was not statistically significant (χ²=3.2, p=0.19). HER2/neu expression showed a significant association with clinical stage (χ²=10.7, p=0.01), whereas ER and PR did notshow significant associations with age, stage or grade.Conclusions:CXCR2 is frequently expressed in breast carcinoma and demonstrates significant association with older age and higher histological grade. These findings support a potential role for CXCR2as a biomarker of tumor aggressiveness and a candidate prognostic stem-cell related marker in breast carcinoma. Larger multicentric studies with survival analysis and molecular validation are required to confirm its clinical utility.

TRIPLE-NEGATIVE VERSUS NON-TRIPLE-NEGATIVE INVASIVE BREAST CARCINOMA: COMPARISON OF CLINICOPATHOLOGICAL CHARACTERISTICS, THERAPEUTIC PROFILE AND OUTCOMES IN A HOSPITAL COHORT

Clinicopathological and Hormone-Receptor Patterns in a Young Breast-Disease Cohort: A Retrospective Analysis of 399 Patients’ Records from 2023–2025 in Tripoli, Libya

This unusually young cohort showed a high burden of grade II–III and locally advanced disease in Libya, but age was not significantly associated with grade, ER, PR, HER2, or disease extent, which limits generalizability.