title: Role of androgen and estrogen receptors as prognostic and potential predictive markers of ductal carcinoma in situ of the breast.
abstract: BACKGROUND
  Ductal carcinoma in situ (DCIS) is a heterogeneous disease that has not been investigated as widely as invasive breast cancer. Thus, the search for biomarkers capable of identifying DCIS lesions that may recur or progress to invasive cancer is ongoing. Although conventional steroid hormone receptors, cell proliferation and other important tumor markers have been extensively studied in invasive tumors, little is known about the role played by androgen receptors (ARs), widely expressed in breast cancer, in DCIS.
  
  
  METHODS
  We performed a retrospective study in a series of 43 DCIS patients treated with quadrantectomy only and followed up for a period ranging from 5 to 13 years, to evaluate the prognostic relevance of conventional biomarkers (estrogen receptor [ER], progesterone receptor [PgR], Ki67, human epidermal growth factor receptor 2 [HER2]) and AR.
  
  
  RESULTS
  Our findings showed that AR and ER were not independent prognostic variables and that an AR/ER ratio cutoff of 1.13 showed a sensitivity of 75% and a specificity of 94% in predicting in situ relapse or progression to the invasive phenotype. Moreover, while the variables considered singly showed area under the curve (AUC) values ranging from 0.52% to 0.77%, the AR/ER ratio reached a very high AUC (0.92%).
  
  
  CONCLUSIONS
  These preliminary results highlight the potentially important role of AR and ER and, in particular, of their ratio, as prognostic indicators of DCIS evolution.
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì-Cesena) - Italy.
authors.forename: Maria Maddalena
authors.initials: MM
authors.lastname: Tumedei
authors.affiliation: Istituto Oncologico Romagnolo (IOR), Forlì - Italy.
authors.forename: Rosella
authors.initials: R
authors.lastname: Silvestrini
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì-Cesena) - Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ravaioli
authors.affiliation: Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Massa
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Maltoni
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rocca
authors.affiliation: Breast Surgery Unit, Morgagni-Pierantoni Hospital, Forlì - Italy.
authors.forename: Secondo
authors.initials: S
authors.lastname: Folli
authors.affiliation: Breast Surgery Unit, Morgagni-Pierantoni Hospital, Forlì - Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Buggi
authors.affiliation: Breast Surgery Unit, Morgagni-Pierantoni Hospital, Forlì - Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Curcio
authors.affiliation: Pathology Unit, Morgagni-Pierantoni Hospital, Forlì - Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Serra
authors.affiliation: Pathology Unit, Santa Maria delle Croci Hospital, Ravenna - Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Puccetti
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy.
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Forlì-Cesena) - Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Bravaccini
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000378:metabolism*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011944:Receptors, Androgen / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011944:Receptors, Androgen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human