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Coordinated expression of oestrogen and androgen receptors in HER2-positive breast carcinomas: impact on proliferative activity
  1. Francini de Mattos Lima Lin1,
  2. Katia Maciel Pincerato2,
  3. Carlos Eduardo Bacchi3,
  4. Edmund Chada Baracat1,
  5. Filomena Marino Carvalho2
  1. 1Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
  2. 2Department of Pathology of Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
  3. 3Department of Surgical Pathology, Consultoria em Patologia, Botucatu, São Paulo, Brazil
  1. Correspondence to Filomena M Carvalho, Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr Arnaldo, 455—Room 1149, São Paulo, SP 01243-903, Brazil; filomena{at}


Aims Human epidermal growth factor receptor 2 (HER2)-positive breast cancers are aggressive neoplasms associated with a variable response to systemic therapies. Therefore, the identification of biomarkers to better characterise this heterogeneity would improve treatment efficacy. The aim of this study was to evaluate the influence of androgen receptor (AR) and oestrogen receptor (ER) on clinicopathological features in a series of HER2-positive breast carcinomas.

Methods A total of 104 carcinomas were selected and reviewed. Immunohistochemical studies for ER, progesterone receptor and Ki-67 were analysed on tumour whole histological sections. AR expression was analysed on samples represented on tissue microarrays. According to steroid receptor expression, cases were classified into three groups: AR positive/ER positive (48 cases), AR positive/ER negative (41 cases) and AR negative/ER negative (13 cases).

Results AR-positive tumours corresponded to 89 (85.6%) of 104 carcinomas. AR-positive carcinomas were associated with a higher frequency of ER and progesterone receptor co-expression and lower proliferative activity determined by the expression of Ki-67. AR-negative carcinomas were more often high grade. The group of AR-positive/ER-negative carcinomas was associated with the highest frequency of apocrine morphological features. The group of AR-negative/ER-negative carcinomas was associated with the highest proliferative activity and the highest frequency of high histological and nuclear grade. The lowest frequency of high-grade tumours and the lowest proliferative activity were seen among tumours with expression of both receptors.

Conclusions These results suggest that co-expression of AR and ER can provide a protective effect based on phenotypical presentation of HER2-positive carcinomas. Furthermore, lack of both steroid hormone receptors characterises the most aggressive phenotype.

  • Breast cancer
  • HER2
  • androgen receptor
  • oestrogen receptor
  • apocrine carcinomas
  • cancer
  • immunocytochemistry
  • molecular pathology

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  • The paper presents evidence that the coordinated expression of both oestrogen and androgen receptors, more than the expression of only one of these markers, defines distinct subtypes of HER2-positive breast carcinomas.

  • Competing interests None.

  • Ethics approval Ethical Committee for Research Projects of the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (CAPPesq) (protocol 0756/08).

  • Provenance and peer review Not commissioned; externally peer reviewed.