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We wish to add a reference to the list included in the paper of Selim and colleagues1 concerning androgen receptors in ductal carcinoma in situ (DCIS) of the breast that appeared in the Journal of Clinical Pathology in the first issue of 2002. Although the authors state1 that androgen receptors in DCIS have not been reported previously, we had studied this and published a paper2 dealing with our observations, in addition to CAG repeat lengths in the androgen receptor in DCIS.
Thank you for this information and the opportunity to reply. Unfortunately, the study of androgen receptor (AR) CAG repeats by Kasami and colleagues1 is not included in the usual searches and this appears to be the reason for overlooking this reference. In this study, cases of fibroadenoma, ductal carcinoma in situ (DCIS), and invasive mammary carcinoma were included. Twenty four cases of DCIS were tested for AR CAG repeats and 10 were tested for AR expression immunohistochemically. Two of 10 cases were positive for AR and these two cases were the only cases with apocrine morphology. However, in our study,2 we found that 19 of 57 cases of DCIS expressed AR. Thirteen of those 19 cases were of non-apocrine morphology. In addition, of the nine morphologically apocrine cases, three lacked AR expression. It seems to be that AR is expressed in a subset of DCIS even without apocrine morphology, but it is not necessarily true that all morphologically apocrine cases of DCIS will express AR. In Kasami and colleague’s study, none of the cases of invasive mammary carcinoma was tested for AR expression, but other studies3,4 have found that a subset of invasive breast carcinomas expresses AR. We feel that a study of AR CAG repeats in benign apocrine metaplasia, which is always immunohistochemically positive for AR,5 together with and without cases of apocrine and/or non-apocrine in situ and invasive breast carcinoma, would be very valuable in highlighting the importance of CAG repeats and apocrine differentiation.
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