Dataset Information

Androgen Receptor Expression and Breast Cancer Survival: Results From the Nurses' Health Studies.

ABSTRACT:

Background

Hormone receptor signaling is critical in the progression of breast cancers, although the role of the androgen receptor (AR) remains unclear, particularly for estrogen receptor (ER)-negative tumors. This study assessed AR protein expression as a prognostic marker for breast cancer mortality.

Methods

This study included 4147 pre- and postmenopausal women with invasive breast cancer from the Nurses' Health Study (diagnosed 1976-2008) and Nurses' Health Study II (1989-2008) cohorts. AR protein expression was evaluated by immunohistochemistry and scored through pathologist review and as a digitally quantified continuous measure. Hazard ratios (HR) and 95% confidence intervals (CI) of breast cancer mortality were estimated from Cox proportional hazards models, adjusting for patient, tumor, and treatment covariates.

Results

Over a median 16.5?years of follow-up, there were 806 deaths due to breast cancer. In the 7?years following diagnosis, AR expression was associated with a 27% reduction in breast cancer mortality overall (multivariable HR?=?0.73, 95% CI = 0.58 to 0.91) a 47% reduction for ER+ cancers (HR?=?0.53, 95% CI = 0.41 to 0.69), and a 62% increase for ER- cancers (HR?=?1.62, 95% CI = 1.18 to 2.22) (P heterogeneity < .001). A log-linear association was observed between AR expression and breast cancer mortality among ER- cancers (HR?=?1.14, 95% CI = 1.02 to 1.26 per each 10% increase in AR), although no log-linear association was observed among ER+ cancers.

Conclusions

AR expression was associated with improved prognosis in ER+ tumors and worse prognosis in ER- tumors in the first 5-10?years postdiagnosis. These findings support the continued evaluation of AR-targeted therapies for AR+/ER- breast cancers.

SUBMITTER: Kensler KH

PROVIDER: S-EPMC6624168 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Androgen Receptor Expression and Breast Cancer Survival: Results From the Nurses' Health Studies.

Kensler Kevin H KH Poole Elizabeth M EM Heng Yujing J YJ Collins Laura C LC Glass Benjamin B Beck Andrew H AH Hazra Aditi A Rosner Bernard A BA Eliassen A Heather AH Hankinson Susan E SE Winer Eric P EP Brown Myles M Tamimi Rulla M RM

Journal of the National Cancer Institute 20190701 7

<h4>Background</h4>Hormone receptor signaling is critical in the progression of breast cancers, although the role of the androgen receptor (AR) remains unclear, particularly for estrogen receptor (ER)-negative tumors. This study assessed AR protein expression as a prognostic marker for breast cancer mortality.<h4>Methods</h4>This study included 4147 pre- and postmenopausal women with invasive breast cancer from the Nurses' Health Study (diagnosed 1976-2008) and Nurses' Health Study II (1989-2008 ...[more]

PMID: 30445651

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Project description:BackgroundPhysical activity is generally associated with better outcomes following diagnosis; however, few studies have evaluated change in pre- to postdiagnosis activity and repeated measures of activity by intensity and type.MethodsWe evaluated physical activity and survival following a breast cancer diagnosis in the Nurses' Health Study and Nurses' Health Study II (n = 9308 women, n = 1973 deaths). Physical activity was evaluated as updated cumulative average of metabolic equivalent of task (MET)-h/wk (assigned per activity based on duration and intensity) and change in pre- to postdiagnosis activity. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsHigher postdiagnosis activity was inversely associated with breast cancer-specific mortality in categories from ≥9 MET-h/wk (vs <3 MET h/wk, HR≥9 to <18 = 0.74 [95% CI = 0.55 to 0.99]; HR≥27 = 0.69 [95% CI = 0.50 to 0.95]; Ptrend = .04) and all-cause mortality from ≥3 MET-h/wk (HR≥3 to <9 = 0.73 [95% CI = 0.61 to 0.88]; HR≥27 = 0.51 [95% CI = 0.41 to 0.63]; Ptrend < .001). Associations were predominantly observed for estrogen receptor-positive tumors and in postmenopausal women. Walking was associated with lower risk of all-cause mortality (≥9 vs <3 MET-h/wk, HR= 0.69 [95% CI = 0.57 to 0.84]) as was strength training. Relative to stable activity pre- to postdiagnosis (±3 MET-h/wk), increases from ≥3 to 9 MET-h/wk were associated with lower all-cause mortality risk (Ptrend < .001). Results were robust to adjustment for prediagnosis physical activity.ConclusionsPhysical activity was associated with lower risk of death following diagnosis. Increased pre- to postdiagnosis activity corresponding to at least 1-3 h/wk of walking was associated with lower risk of death. These results provide further impetus for women to increase their activity after a breast cancer diagnosis, though reverse causation cannot be fully excluded.

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Dataset Information

Androgen Receptor Expression and Breast Cancer Survival: Results From the Nurses' Health Studies.

Background

Methods

Results

Conclusions

Publications

Androgen Receptor Expression and Breast Cancer Survival: Results From the Nurses' Health Studies.

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