Researchers from Tuskegee University developed a new testing method to detect the most aggressive and fatal form of breast cancer in black women. The finding uncovered a fourth biological testing marker used to subtype breast cancer, and could offer a potential breakthrough in early detection and more “precise” methods of treating the disease.
A total of 1258 patients were analyzed for the study which assessed androgen receptor (AR) and mRNA expression in 925 tumors from The Cancer Genome Atlas (TCGA), as well as 136 tumors in two confirmation sets, in addition to determining AR protein expression in 171 tumors from a “multi-institutional cohort.” The findings determined that androgen receptors could be used as a prognostic marker for breast cancer, particularly in triple and quadruple negative breast cancers, or tumors that “lack AR expression,” as detailed in a report published last week in PLOS One, a peer-reviewed medical journal.
Statistically, AR-negative patients are diagnosed at a younger age, while the average age of AR-positive patients is 49. According to the study, tumors in black patients express AR at lower rates in comparisons to white women. Black women are more likely to be diagnosed with triple negative breast cancer (a more aggressive type of breast cancer) at a younger age.
“Scientifically speaking, our research suggests that the expression of the androgen receptor (the receptor for testosterone), should be added to the current set of prognostic markers — estrogen, progesterone and human epidermal growth factor receptor [two] — used to test for classify and determine the aggressiveness of breast cancer,” Dr. Clayton Yates, professor of biology and director of Tuskegee’s multidisciplinary Center for Biomedical Research who published the findings in PLOS One.
“As with any fight, you have to know your enemy,” he added. “Imagine going into battle not knowing if you needed a BB gun, a shotgun,or a bazooka. With this additional testing option, physicians will be able to better define the enemy and develop a more precise treatment plan. This, in turn, promises to be more effective for the patient — not to mention safer and less expensive — in the long run.”
The team, led by assistant research professor Shweta Tripathi and Raymond Hugely, a master’s student in the university’s Department of Biology & Center for Cancer Research, collaborated with other medical researches like Detroit-based Henry Ford Health System genetics professor Dr. Melissa Davis, and Dr. Lisa Newman, director of the Henry Ford Cancer Institute’s Breast Oncology Program and medical director for the International Center for the Study of Breast Cancer Subtypes.
Most of the data analyzed came from partnering universities and medical schools including Dr. William Grizzle from the University of Alabama at Birmingham.
“The addition of androgen receptor as a fourth biomarker could be game-changing, in not only how we treat all patients with TNBC (triple negative breast cancer), but really sets the foundation for this unique subtype called QNBC (quadruple negative breast cancer),” said Windy Dean-Colomb, medical oncologist Dr. and medical director of oncology for St. Patrick CHRISTUS Hospital in Lake Charles, Louisiana.
Breast cancer is the second-most commonly diagnosed cancer in women, although black women are more likely to be diagnosed at later stages, thus making them more likely to succumb to the disease.
“Study after study proves that early detection is the key to long-term survival,” Yates said. “Our new testing method shows significant promise for as a prognostic marker for the most aggressive types of breast cancer — African-American women that lack AR expression are diagnosed 10 years earlier than patients with positive AR expression.”
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