Min Sun Bae MD, PhD, Presenter: Nothing to Disclose

Woo Kyung Moon, Abstract Co-Author: Nothing to Disclose

Won Hwa Kim MD, MS, Abstract Co-Author: Nothing to Disclose

Su Hyun Lee MD, Abstract Co-Author: Nothing to Disclose

Jung Min Chang MD, Abstract Co-Author: Nothing to Disclose

Nariya Cho MD, Abstract Co-Author: Nothing to Disclose

Hye Ryoung Koo MD, Abstract Co-Author: Nothing to Disclose

So Yeon Park, Abstract Co-Author: Nothing to Disclose

Androgen receptor (AR) is expressed in approximately 15% to 25% of triple-negative breast cancer (TNBC) and emerging data suggests that AR may serve as a therapeutic target for a subset of TNBC. We retrospectively reviewed imaging findings for 102 patients with TNBC on mammogram, ultrasound (US), and MRI to determine if AR-positive and AR-negative tumors have distinguishing imaging features.

A total of 102 consecutive patients (median age, 52 years; range, 28-81 years) with triple-negative (ER-/PR-/HER2-) invasive breast cancers and immunohistochemical data on AR status were included in this study. Two dedicated breast radiologists (5 and 22 years of breast imaging experience, respectively) reviewed the mammogram, US, and MRI without knowledge of the clinicopathological findings based on the ACR BIRADS lexicon. If different imaging findings were assigned by the two readers, a consensus was reached after the findings were discussed. A cutoff value of 10% was used to define AR positivity. The association of AR status with all imaging features was assessed with Fisher exact test. 

Twenty-four (24%) patients had AR-positive TNBC and 78 (76%) patients had AR-negative TNBC. Lesion shape on mammogram (P = .008), US (P = .001), and MRI (P = .001), lesion margins on mammogram (P = .004) and US (P = .003), echo pattern on US (P = .009), calcifications on mammogram (P < .0001), and lesion type on MRI (P = .003) were significantly associated with AR status. AR-positive TNBC was more likely to have irregular masses (88% vs 41%), indistinct margins (84% vs 56%), and non-complex hypoechoic masses (96% vs 65%) and be associated with calcifications (54% vs 12%) or nonmass-like enhancement (17% vs 0%).

Our results suggest that AR-positive and AR-negative TNBC have different imaging features.

Understanding the imaging heterogeneity of TNBC may be helpful in identifying a subset of TNBC with AR expression, which has been shown to be associated with increased mortality among TNBC patients.

Bae, M, Moon, W, Kim, W, Lee, S, Chang, J, Cho, N, Koo, H, Park, S, Triple-negative Breast Cancers: Multimodality Imaging Features of Tumors with and without Androgen Receptor Expression.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13022425.html