Exploring the Role of Androgen Receptor Expression in Triple-Negative Breast Cancer: Implications for Targeted Therapy

Exploring the Role of Androgen Receptor Expression in Triple-Negative Breast Cancer: Implications for Targeted Therapy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring the Role of Androgen Receptor Expression in Triple-Negative Breast Cancer: Implications for Targeted Therapy Shubham Varshney, Deepa HC, Padmapriya Jaiprakash, Shivani Gupta This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6927480/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Triple-negative breast cancers (TNBC) account for 12–24% of breast cancer cases. They are common in young females with high-grade and poor prognosis. Androgen receptor (AR) is emerging as a new therapeutic target in TNBC. Methods This retrospective study was undertaken to evaluate the expression of AR by immunohistochemistry in TNBC, to study its relation to potential prognostically significant factors, and to calculate overall survival (OS) & disease-free survival (DFS) in AR-positive and AR-negative cases. Results A total of 78 TNBC cases were studied for expression of AR, of which 17 (22%) showed AR positivity and presented at an older age. Around 10 cases showed metastasis at presentation, with lung being the most common organ involved in AR-negative group with statistical significance(p-0.026). Histologic features like infiltrating borders, Ductal carcinoma in-situ (DCIS), and apocrine differentiation were mostly seen in AR-positive tumors, while multifocality, necrosis, LVI, and Modified Bloom Richardson(MBR) grade 3 were seen frequently in AR-negative tumors. The tumor size was larger in AR-negative tumors with a statistically significant value(p-0.036). A statistically significant value(p-0.037) was found with AR expression and low Ki-67 index, indicating higher disease-free survival. Although overall survival and disease-free survival were better in AR-positive than AR-negative, a statistical significance could not be established owing to the small study population. Conclusion AR expression can be a prognostic factor for disease outcome in TNBC patients, and along with Ki-67 might be useful to sub-classify risk in these patients. Thus, AR can be used as a predictive factor for new targeted treatment in TNBC. Androgen receptor Breast Cancer Ki67 index Triple Negative Breast Cancer Figures Figure 1 Figure 2 1. BACKGROUND Breast cancer is the most frequent cancer in women and the fifth leading cause of cancer death worldwide (1,2). Triple-negative breast cancers (TNBC) alone account for approximately 12 to 24% of the cases (3). TNBC is defined as “absence of expression for estrogen receptor (ER) and progesterone receptor (PR) by immunohistochemistry (IHC), absence of over-expression for human epidermal growth factor receptor factor Her 2/neu (HER 2) by IHC and absence of amplification of HER2 by Fluorescent in situ hybridization (FISH)”(4). TNBC is an aggressive histological subtype that more commonly affects young females and has a higher histological grade and more advanced disease. The prevalence of TNBC is found to be higher in India as compared to Western countries (5). The overall prevalence of TNBC in northern, southern, eastern & western regions of India was 28%, 34%, 30%, & 31%, respectively, and an overall combined prevalence of 31% in India (5). The histologic features of TNBC are infiltrating ductal carcinoma- not otherwise specified (IDC-NOS) grade 3 with high mitotic rate, pushing margin of invasion, geographic tumor necrosis, lymphocytic stromal response, solid-/sheet-like or ribbon-like growth pattern, large central zone of fibrosis/necrosis, metaplastic differentiation, myoepithelial differentiation, salivary gland differentiation, apocrine differentiation, secretory differentiation (6). Owing to their aggressive behaviour, the rate of distant recurrences is more as compared to local recurrence. Metastatic TNBCs have more propensity to involve viscera such as lungs and brain and less propensity towards bones as in contrast to their ER positive counterpart. Most patients will present with multiple site involvement (7). TNBC is a heterogeneous disease comprising different biological subtypes recognized by different gene expression profiling studies (8,9). This heterogeneity explains the need to develop new therapeutic strategies and alternatives to the currently used drugs (Table 1 ). Thus, androgen receptor (AR) is emerging as a new marker and a potential new therapeutic target in the treatment of breast cancer (9). Table 1 Four major classifications of TNBC and promising subtype-directed personalized therapy BASAL-LIKE MESENCHYMAL IMMUNE LUMINAL ANDROGEN Biologic pathway DNA damage response Cell cycle pathway EMT, Wnt and Notch signaling Immune cell signaling Luminal androgen signaling Targeted therapy Platinum-based PARP inhibitor MET inhibitor FGFR inhibitor mTOR inhibitor Immune checkpoint inhibitor Androgen blockade PIK3CA The mainstay of treatment for TNBC is cytotoxic chemotherapy. Despite having a heterogeneous nature and no known targetable biomarker, TNBC has higher response rates to neoadjuvant chemotherapy compared to other breast cancer subtypes; this phenomenon is known as TNBC paradox (10). AR is a member of the steroid receptor family of ligand-activated nuclear transcription factors, which have a similar structure as that of other steroid hormones like estrogen, progesterone, glucocorticoid, and thyroid hormone receptors (11). It links a transcription factor that controls specific genes involved in different cellular processes; by either stimulating or suppressing both cell proliferation and apoptosis, depending on the concurrent signaling pathways activated (12). The median survival of TNBC patients with metastasis is only 12–18 months compared to 5 years for patients with metastatic HER-2 positive breast cancer, highlighting the need for more effective systemic therapies for this group of patients (13). Furthermore, for metastatic TNBC, median progression-free survival after first-line chemotherapy is only 3–4 months, highlighting the need for the development of new therapies for the treatment of metastatic TNBC. Loibl and colleagues reported that AR-negative tumors were more likely to achieve a pathologic complete response (pCR) with neoadjuvant docetaxel/ doxorubicin/ cyclophosphamide chemotherapy than AR-positive tumors. However, despite their decreased responsiveness to neo-adjuvant chemotherapy (NAC), AR-positive tumors had significantly better DFS and OS than AR-negative tumors. Similar findings were reported by Masuda et al with a decreased pCR rate among the luminal androgen receptor (LAR) subtype (10%) as compared to all TNBC (28%)(14). There has been enough evidence in the literature regarding androgen receptor (AR) testing as a biomarker and a therapeutic target in TNBC, but however, there is a paucity of such studies in India. Hence, this study was undertaken to evaluate the expression of AR by immunohistochemistry in TNBC, and to study its relation to potential prognostically significant factors like tumor size and site, laterality, histological subtype, tumor grade and stage, necrosis, LVI, DCIS and Ki67 index and also to calculate overall survival (OS) & disease-free survival (DFS) in AR-positive and AR-negative cases. 2. Methods In this retrospective study, 78 female breast lump resection cases of TNBC (including Her2neu 1 + and 2 + with negative FISH) without prior neoadjuvant therapy between January 2016 and December 2017 were studied for Androgen receptor (AR) status, which was evaluated by immunohistochemistry (Dako, Denmark A/S, Glostrup, Denmark) on TMA blocks (Institutional Ethics Committee Number -IEC 454/2018). A threshold to define AR positivity was defined based on a study done by Astvatsaturyan K et al. (4), where AR immunoreactivity in at least 1% of tumor cell nuclei was considered the most appropriate threshold. The patients were further divided into two groups: AR Positive & AR Negative. Slides from already proven cases of BPH were taken as external positive control, and normal ductal lining epithelial cells were taken as internal positive control to ensure the quality of the antibody and technique. Of the total 78 cases, only 59 cases had the Ki-67 index available. These cases were further categorized into Low Ki-67 expression (< 10) and High Ki-67 expression (≥ 10), according to Keam et al (15). Of the total 78 patients, 51 followed up in the Medical Oncology department at an interval of 3 months during each hospital visit. These patients, after definitive diagnosis and surgery, were treated with at least 4 cycles of Doxorubicin and Cyclophosphamide every 3 weeks over 12 weeks, followed by Paclitaxel again weekly over 12 weeks. Radiotherapy was given in patients with T3 stage, node positivity, and patients who underwent BCS. Disease outcome was defined in terms of disease-free survival (DFS), overall survival (OS), recurrence, and lost to follow-up. Disease-free survival (DFS) was defined as the time from the date of surgery to the date of first recurrence, metastasis, or mortality associated with breast cancer. Overall survival (OS) was defined as the period from the date of surgery to the date of mortality associated with breast cancer or the last follow-up time. Both OS and DFS were correlated with the immunohistochemical expression of AR. The entire data was statistically analyzed using Statistical Package for Social Sciences (SPSS version 20.0, IBM Corporation, USA) for MS Windows. Categorical variables were represented as frequency table and Continuous variables as Mean ± SD/ Median (Min, Max). The inter-group statistical comparison of the distribution of categorical variables was tested using the Chi-Square test or Fisher’s exact probability test; continuous variables were done using the independent sample t-test, and non-normally distributed continuous variables were done using the Mann-Whitney U test. In the entire study, the p-values less than 0.05 were statistically significant. Association with survival was analysed by the Kaplan-Meier plot and log-rank test. The Cox proportional hazard model was used to compute the univariate hazard ratio for the Ki-67% index with 95% confidence intervals (95%CI). 3. Results 3.1 . Patient overview 78 female patients with TNBCs were identified. The various clinicopathological parameters are summarised in Table 2 and Table 3. 3.2. Prevalence of Androgen receptor (AR) AR expression was positive in 17/78 (22%) cases and was negative in 61/78(78%) TNBC cases, with a cutoff of staining of >1% cells, irrespective of the staining intensity. 3.3. Clinical features TNBC patient's ages ranged from 22-78 years, with a median of 51 years. TNBC involved mostly right breast with 43 (55.1%) cases, with 8/17 (47.1%) AR-positive TNBC and 35 (57.4%) AR negative TNBC. The upper outer quadrant (UOQ) was most involved; with 32/61 (52.5%) cases in AR negative TNBCs and 8/17 (47.1%) in AR positive TNBCs. Out of 78 TNBC patients, 47 (60.3%) presented with axillary swelling, out of which 36 (59%) were AR-negative. Overall, 25 cases (32.1%) presented with skin involvement, but as compared to AR negative cases, 19 (31.1%) AR positive showed slightly more involvement with 6/17 cases (35.3%). AR-positive tumors showed more nipple involvement. On mammography, of 7 BI-RADS assessment categories, 2 groups were made: 0-3 (benign) and another 4-6 (suspicious/malignant). Of the total 78 cases, only 7 cases were categorized as benign category, out of which 2 (11.8%) were AR-positive and 5 were AR-negative (8.2%). Metastasis was seen in only 10 (12.8%) cases out of which 7 (11.5%) were AR negative and 3 (17.6%) were AR positive. The most commonly involved organ was the lung in 5/10 (8.2%) cases, all being AR negative. The distribution of organ involvement among AR-positive and AR-negative cases showed statistical significance (p= 0.026). 3.4. Gross and microscopy: Most of the TNBC tumors showed infiltrating borders 52/78 (66.7%). Out of which, 22/61 (36.1%) of AR-negative tumors showed circumscription, while only 4/17 (23.5%) of AR-positive tumors showed circumscribed borders. Out of 78 TNBCs, only 5 (6.4%) showed multifocality, with 4/61 (6.6%) being AR-negative and only a single case in the AR-positive group. The most common histologic subtype seen was infiltrating duct carcinoma (IDC)- NOS (63 cases-80.8%) followed by metaplastic carcinoma (9 cases- 11.1%); others were one case each of secretory carcinoma, invasive apocrine carcinoma, bilateral lobular carcinoma and 3 cases of IDC with medullary features (fig 1). Interestingly, out of 9 cases of metaplastic tumors, 2 showed positivity for the AR receptor. In most of the TNBC tumors, DCIS was absent, and only 16 cases showed DCIS, with AR-positive tumors showing more DCIS component 5/17 (29.4%) as compared to the AR-negative group, wherein only 18% of the tumors showed DCIS component. Necrosis was a feature seen in 53.8% (42/78) TNBC tumors, with AR-negative tumors showing 57.4% (35/61) tumor necrosis as compared to 41.2% (7/17) AR-positive tumors. A total of 7 cases showed apocrine differentiation, of which only 11.8% (2/17) were AR-positive, and the remaining 5, which is 8.2%, were AR-negative tumors. A total of 19 cases (24.4%) showed LVI, out of which 17 (27.9%) were AR-negative and 2 (11.8%) were AR-positive. Most of the TNBC tumors, 47/78 (60.3%), showed MBR grade 3 with similar percentages, 60.7% and 58.8%, seen in AR-negative and AR-positive groups, respectively. Only 2 cases (11.8%) AR-positive and 3 (4.9%) AR-negative tumors show MBR Grade 1. In the present study, out of 59 available Ki -67 cases, only 4 cases showed a low Ki-67 index, and all showed AR Positivity. All the AR negative cases (100%) showed a high Ki-67 index (≥ 10), with only 9 (69.2%) cases being AR-positive. This difference was statistically significant with a p-value (<0.05). Also, the median Ki-67 was 60% in AR negative tumors, which was also significantly higher as compared to AR-positive tumors with a median of only 10% (fig 2-A). 3.5. Pathological (p) TNM Staging and Clinical Staging: There was no statistical difference between the two groups when the patients were categorized into different stages based on tumor size (T), number of nodes involved (N), and local or distant metastasis (M) [p value = >0.05]. 3.6. Recurrence and Organ Involved in Recurrence: In this study, around 25% (20/78) of subjects presented with recurrence out of which 18 (29.5%) were AR negative and only 2 (11.8%) cases were AR positive. The most common organ involved in recurrence was the lung (6/18), followed by multi-organ (≥2 organs) involvement. 3.7. Swelling size and tumor size: For this study, swelling size was defined as the clinically measured size of the tumor at the time of presentation to the clinician. Tumor size was defined as the size of the tumor measured by pathologist at the time of grossing. But when divided into 3 groups, AR-positive tumors were associated with smaller tumor size as compared to AR-negative tumors showing statistical significance (p = 0.03) (table 4) 3.8. Disease-free survival and overall survival: The mean DFS for 51 TNBC cases was 28.6 months, which was higher in AR-positive TNBC (35.6 months) as compared to AR-negative TNBC (26.7 months) but was statistically non-significant (p = 0.091). The median overall DFS was 31 months, and for AR negative, it was 28 months. The mean OS for a total of 51 follow-up cases was 39.2 months. The mean OS for the AR-positive group was slightly higher at 37.5 months versus 36.2 months for the AR-negative group but with a non-significant p-value. The median overall OS was 38 months, and for the AR negative group, it was 31 months. Median OS and DFS for the AR-positive group could not be computed as the percentage of censored observation was very high. The Kaplan Meier curve for DFS & OS with AR status shows a trend that depicts a higher OS & DFS for AR-positive TNBCs when compared to AR-negative TNBCs but was not statistically significant owing to the small study population (table 5 and 6) (fig 2- B and C). 4. Discussion Although having the reputation of being an aggressive form of breast cancer around 10 (12.8%) cases in the current study presented with distant metastasis. Out of 10, 7 belonged to the AR negative category, and 3 belonged to the AR positive category. The majority of metastasis was seen in the lungs, which was similar to the study done by Zakaria et al. (16), which also showed 25.9% (20/77) cases metastasizing to the lungs. In the current study, 76.5% of AR-positive tumors showed infiltrating borders as compared to 63.9% of AR-negative tumors. This was in concordance with a study done by Thike et al. (17) and colleagues, which also demonstrated infiltrating borders (p = 0.032) in AR-expressing TNBCs. In a study done by Bae et al. (18), around 6.5% of AR-negative tumors showed multifocality, which was similar to the present study (6.6%). Only 1 case in the AR-positive group showed multifocality in both studies. Almost 54% of TNBC tumors presented with necrosis and, out of which 84% belonged to the AR-negative group & only 16% belonged to the AR-positive group, implying that AR expression in TNBC tumors indicates a good prognosis. None of the previous studies could establish an association between AR expression in TNBC and lymphovascular invasion (LVI). Nevertheless, studies done by Bae et al., (18) Thike et al.(17), and Asano et al.(19), showed LVI being more frequently present(86%, 65%, and 80% respectively) in the AR negative group as compared to AR positive group, which was similar to the present study findings(90%) and is a marker of better prognosis Very few studies have compared AR expression with DCIS. In a study done by Bae et al. (18), AR-positive cancers were more likely to have a DCIS component (p-value = 0.001) than AR-negative tumors. In another study by Thike et al. (17), AR-positive tumors showed more DCIS components as compared to AR-negative tumors. In the current study also, the DCIS component was more expressed in the AR positive group (29.4%) as compared to the AR negative group (18%). Though TNBCs generally show a high MBR grade, AR-positive tumors have been associated with a low or intermediate histologic grade (20). Few studies could establish the association (16,17,21,22,23) while others could not (4,19,24,25,26). We also did not find any association between MBR grade and AR expression. In the present study, we found that AR-positive tumors are significantly associated with smaller tumor sizes as compared to AR-negative tumors. This finding was consistent with most of the studies done to date (19,21,27). Several studies have shown that AR-positive immunostaining is associated with a lower mitotic index (4,24,28). In the existing study also, AR expression was significantly associated with a low Ki-67 index, while its loss of expression was associated with a high Ki-67 (≥ 10) index. It was also seen that the median Ki-67 was 60% in AR-negative tumors, which was significantly higher as compared to AR-positive tumors, which were 10%. In the current study, around 82% of AR-positive tumors presented with T2 stage as compared to 54.1% in AR-negative tumors. Also, around 65% of AR-positive tumors showed no metastasis to lymph nodes, which was in conjugation with the studies done by Zakaria et al(16) and Xuan et al. (26) Similarly in clinical staging 64.7% AR expressing tumors belonged to Stage II as compared to 50.8% in AR negative tumors; which again implies that AR positivity in TNBC is associated with lower pathological & clinical stage. Based on analysis done by Thike et al. (17) and Luo et al. (29), AR-negative tumors are significantly associated with recurrences and distant metastasis. In the current study also, around 30% of AR-negative patients had recurrence as compared to 11.8% in AR-positive patients. Moreover, as far as the distant metastasis pattern of TNBC is concerned, previous studies reported a higher incidence of visceral metastasis as compared to bone metastasis, favoring a hematogenous spread in TNBC patients (30,31). Consistently, our present study revealed that overall lung metastasis (7.7%) was the most frequent while brain metastasis (1.3%) was the least frequent, and bone metastasis was relatively lower (3.8%). We found that OS and DFS for AR-positive patients were better as compared to AR-negative patients but were non-significant. AR expression overall had a good effect on survival in the present study, and patients with AR-positive TNBC survived longer, with lower recurrence than those with AR-negative TNBC. In a meta-analysis done by Wang C et al. (32), which included 2826 TNBC patients, AR positivity showed no effect on OS but was associated with a lower risk of disease recurrence. Another study done by McGhan et al. (33) and Mehrdad et al. (34) showed that OS was similar between AR-positive and AR-negative patients. Alternatively, He et al. (35) demonstrated that the expression of AR is a favorable prognostic factor in terms of both OS (HR 0.34, p = 0.011) and DFS (HR 0.40, p = 0.008). A recent systematic meta-analysis of 19 studies consisting of 7693 patients displayed that the expression of AR is associated with improved OS & DFS regardless of ER expression, with approximately a doubling of OS at 3 and 5 years. Also, in the present study, on univariate analysis of Ki-67 with DFS, we found that the high Ki-67 index predicts almost two times higher incidence of lower DFS as compared to the low Ki-67 index group. Thus, Ki-67 can be further used to divide TNBC into two groups and can also act as a prognostic indicator. These findings were in concordance with the studies done by Keam et al (15) and Ricciardi et al (36), both of which demonstrated that high Ki-67 index levels are independent predictors of OS and DFS in TNBC tumors and are associated with a more aggressive clinico- pathological features despite a higher pathologic complete response (pCR) rate. 5. Conclusion It is important to include an assessment of AR as a part of routine evaluations of at least TNBC patients and, preferably, all breast carcinomas. From this study, we can support the value of AR expression and can also rely on AR expression as a prognostic factor for disease outcomes in TNBC patients. Also, AR can be used as a predictive factor for new targeted treatment in this aggressive sub-type of breast cancer. Thus, both AR & Ki-67 status together might be useful prognostic markers in TNBC in order to sub-classify the risk of these patients. Abbreviations Triple-negative breast cancers (TNBC) Androgen receptor (AR) overall survival (OS) disease-free survival (DFS) Ductal carcinoma in situ (DCIS) Lymphovascular invasion (LVI) Modified Bloom Richardson (MBR) Estrogen receptor (ER) Progesterone receptor (PR) Human epidermal growth factor receptor factor Her 2/neu (HER 2) Immunohistochemistry (IHC) Fluorescent in situ hybridization (FISH) Pathologic complete response (pCR) Infiltrating ductal carcinoma- not otherwise specified (IDC -NOS) Neo- adjuvant chemotherapy (NAC) Luminal androgen receptor (LAR) Declarations Ethics approval and consent to participate: Kasturba Medical College and Kasturba Hospital Institutional Ethics Committee Number -IEC 454/2018, adhered to declaration of Helsinki, need for consent to participate was waived by institutional review board. Consent for publication: NA Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Funding: The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Authors contribution: All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [full name], [full name] and [full name]. The first draft of the manuscript was written by [full name] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Acknowledgements: NIL References Boyle P. Triple-negative breast cancer: Epidemiological considerations and recommendations. Ann Oncol. 2012;23(SUPPL. 6):8–13. Iarc. IA for R on CWHO. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Globocan. 2012; v1.0 Schmadeka R, Harmon BE, Singh M. Triple-negative breast carcinoma: Current and emerging concepts. Am J Clin Pathol. 2014;141(4):462–77. Astvatsaturyan K, Yue Y, Walts AE, Bose S. Androgen receptor positive triple negative breast cancer: Clinicopathologic, prognostic, and predictive features. PLoS One. 2018 Jun 1;13(6):1–16. Sandhu GS, Erqou S, Patterson H, Mathew A. Prevalence of Triple-Negative Breast Cancer in India: Systematic Review and Meta-Analysis. J Glob Oncol. 2016;2(6):412–21. Putti TC, Abd El-Rehim DM, Rakha EA, Paish CE, Lee AHS, Pinder SE, et al. Estrogen receptor-negative breast carcinomas: A review of morphology and immunophenotypical analysis. Mod Pathol. 2005;18(1):26–35. Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, et al. Triple-negative breast cancer: Clinical features and patterns of recurrence. Clin Cancer Res. 2007;13(15):4429–34 Ahn SG, Kim SJ, Kim C, Jeong J. Molecular classification of triple-negative breast cancer. J Breast Cancer. 2016;19(3):223–30. Bianchini G, Balko JM, Mayer IA, Sanders ME, Gianni L. Triple-negative breast cancer: Challenges and opportunities of a heterogeneous disease. Nat Rev Clin Oncol. 2016;13(11):674–90. Carey LA, Dees EC, Sawyer L, Gatti L, Moore DT, Collichio F, et al. The triple negative paradox: Primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007;13(8):2329–34. Yu Q, Niu Y, Liu N, Zhang JZ, Liu TJ, Zhang RJ, et al. Expression of androgen receptor in breast cancer and its significance as a prognostic factor. Ann Oncol. 2011;22(6):1288–94. Gerratana L, Basile D, Buono G, Placido S De, Giuliano M, Minichillo S, et al. Androgen receptor in triple negative breast cancer : A potential target for the targetless subtype. Cancer Treat Rev. 2018;68(April):102–10. Swain SM, Baselga J, Kim SB, Ro J, Semiglazov V, Campone M, et al. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N Engl J Med. 2015 Feb 19;372(8):724-34. Masuda H, Baggerly KA, Wang Y, Zhang Y, Gonzalez-Angulo AM, Meric- Bernstam F, et al. Differential response to neoadjuvant chemotherapy among 7 triple-negative breast cancer molecular subtypes. Clin Cancer Res. 2013 Oct 1;19(19):5533-40. Keam B, Im SA, Lee KH, Han SW, Oh DY, Kim JH, et al. Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis. Breast Cancer Res. 2011;13(2). Zakaria F, El-Mashad N, Mohamed D. Androgen receptor expression as a prognostic and predictive marker in triple-negative breast cancer patients. Alexandria J Med [Internet]. 2016;52(2):131–40. Thike AA, Chong LYZ, Cheok PY, Li HH, Yip GWC, Bay BH, et al. Loss of androgen receptor expression predicts early recurrence in triple-negative and basal-like breast cancer. Mod Pathol [Internet]. 2014;27(3):352–60. Bae MS, Park SY, Song SE, Kim WH, Lee SH, Han W, et al. Heterogeneity of triple-negative breast cancer: mammographic, US, and MR imaging features according to androgen receptor expression. Eur Radiol. 2015;25(2):419–27. Asano Y, Kashiwagi S, Goto W, Tanaka S, Morisaki T, Takashima T, et al. Expression and clinical significance of androgen receptor in triple-negative breast cancer. Cancers (Basel). 2017;9(1):1–10. Agoff SN, Swanson PE, Linden H, Hawes SE, Lawton TJ. Androgen Receptor Expression in Estrogen Receptor-Negative Breast Cancer: Immunohistochemical, Clinical, and Prognostic Associations. Am J Clin Pathol. 2003;120(5):725–31 Farag K, Elfarargy O, El Shorbagy S, Ahmed S, Harb O, Amin R, et al. Prevalence of androgen receptors expression in triple negative breast cancer patients and its correlation with clinicopathological criteria: Our institutes experience. J Clin Oncol. 2017;35(15_suppl):e12584–e12584. Tang D, Xu S, Zhang Q, Zhao W. The expression and clinical significance of the androgen receptor and E-cadherin in triple-negative breast cancer. Med Oncol. 2012;29(2):526–33. Alshenawy HAS. Prevalence of androgen receptors in invasive breast carcinoma and its relation with estrogen receptor, progesterone receptor and Her2/neu expression. J Egypt Natl Canc Inst [Internet]. 2012;24(2):77–83. Bae MS, Park SY, Song SE, Kim WH, Lee SH, Han W, et al. Heterogeneity of triple-negative breast cancer: mammographic, US, and MR imaging features according to androgen receptor expression. Eur Radiol. 2015;25(2):419–27. Giannos A, Filipits M, Zagouri F, Brandstetter A, Tsigginou A, Sotiropoulou M, et al. Expression of ARs in triple negative breast cancer tumors: A potential prognostic factor? Onco Targets Ther. 2015;8:1843–7 Liu YX, Zhang KJ, Tang LL. Clinical significance of androgen receptor expression in triple negative breast cancer-an immunohistochemistry study. Oncol Lett. 2018;15(6):10008–16. Yang WT, Dryden M, Broglio K, Gilcrease M, Dawood S, Dempsey PJ, et al. Mammographic features of triple receptor-negative primary breast cancers in young premenopausal women. Breast Cancer Res Treat. 2008;111(3):405–10. Mrklić I, Pogorelić Z, Ćapkun V, Tomić SŽ. Expression of androgen receptors in triple negative breast carcinomas. Acta Histochem. 2013;115(4):344–8. Luo X, Shi YX, Li ZM JW. Expression and clinical significance of androgen receptor in triple negative breast cancer. China J Cancer. 2010;29(6):585–90. Molnár IA, Molnár BÁ, Vízkeleti L, Fekete K, Tamás J, Deák P, et al. Breast carcinoma subtypes show different patterns of metastatic behavior. Virchows Arch. 2017;470(3):275–83. Yao Y, Chu Y, Xu B, Hu Q, Song Q. Risk factors for distant metastasis of patients with primary triple-negative breast cancer. Biosci Rep. 2019;39(6):1–10. Wang C, Pan B, Zhu H, Zhou Y, Mao F, Lin Y, et al. Prognostic value of androgen receptor in triple negative breast cancer: A meta-analysis. Oncotarget. 2016;7(29):46482–91. McGhan LJ, McCullough AE, Protheroe CA, Dueck AC, Lee JJ, Nunez- Nateras R, et al. Androgen receptor-positive triple negative breast cancer: A unique breast cancer subtype. Ann Surg Oncol. 2014 Feb;21(2):361-7. Payandeh M, Shazad B, Madani SH, Ramezani M, Sadeghi M. Androgen receptor expression and its correlation with other risk factors in triple negative breast cancers: A report from Western Iran. Asian Pac J Cancer Prev. 2016;17(7):3321-4. He J, Peng R, Yuan Z, Wang S, Peng J, Lin G, et al. Prognostic value of androgen receptor expression in operable triple-negative breast cancer: A retrospective analysis based on a tissue microarray. Med Oncol. 2012 Jun;29(2):406-10. Ricciardi GRR, Adamo B, Ieni A, Licata L, Cardia R, Ferraro G, et al. Androgen receptor (AR), E-Cadherin, and Ki-67 as emerging targets and novel prognostic markers in triple-negative breast cancer (TNBC) patients. PLoS One. 2015;10(6):1–11. Tables Table 1: Four major classifications of TNBC and promising subtype-directed personalized therapy BASAL-LIKE MESENCHYMAL IMMUNE LUMINAL ANDROGEN Biologic pathway DNA damage response Cell cycle pathway EMT, Wnt and Notch signaling Immune cell signaling Luminal androgen signaling Targeted therapy Platinum-based PARP inhibitor MET inhibitor FGFR inhibitor mTOR inhibitor Immune checkpoint inhibitor Androgen blockade PIK3CA Table 2: Distribution of clinicopathological parameters according to Androgen Receptor (AR) expression. Characteristic All cases (n=78) Androgen Receptor (AR) P-value Negative (n=61) Positive (n=17) Age (years) Mean ± SD 50.5 ± 12.5 50.2 ± 12.4 51.3 ± 13.1 0.758 Median (min – max) 51.0 (22 - 78) 51.0 (22 - 78) 53.0 (30 - 77) ≤35 years 9 (11.5%) 6 (9.8%) 3 (17.6%) 0.400 >35 years 69 (88.5%) 55 (90.2%) 14 (82.4%) Laterality 0.142 Right 43 (55.1%) 35 (57.4%) 8 (47.1%) Left 34 (43.6%) 26 (42.6%) 8 (47.1%) Bilateral 1 (1.3%) 0 1 (5.9%) Tumor Site 0.862 UOQ 40 (51.3%) 32 (52.5%) 8 (47.1%) UIQ 11 (14.1%) 9 (14.8%) 2 (11.8%) LOQ 2 (2.6%) 2 (3.3%) 0 LIQ 5 (6.4%) 4 (6.6%) 1 (5.9%) Central 5 (6.4%) 3 (4.9%) 2 (11.8%) Multicentric 15 (19.2%) 11 (18.0%) 4 (23.5%) Axillary Swelling 0.783 Absent 31 (39.7%) 25 (41.0%) 6 (35.3%) Present 47 (60.3%) 36 (59.0%) 11 (64.7%) Metastasis at Presentation 0.682 Absent 68 (87.2%) 54 (88.5%) 14 (82.4%) Present 10 (12.8%) 7 (11.5%) 3 (17.6%) Organ Involved 0.026 * None 68 (87.2%) 54 (88.5%) 14 (82.4%) Brain 1 (1.3%) 1 (1.6%) 0 Liver 2 (2.6%) 0 2 (11.8%) Bone 1 (1.3%) 1 (1.6%) 0 Lung 5 (6.4%) 5 (8.2%) 0 ≥ 2 Organs 1 (1.3%) 0 1 (5.9%) BI-RADS Score 0.643 0 – 3 7 (9.0%) 5 (8.2%) 2 (11.8%) 4 – 6 71 (91.0%) 56 (91.8%) 15 (88.2%) Skin Involvement 0.774 Absent 53 (67.9%) 42 (68.9%) 11 (64.7%) Present 25 (32.1%) 19 (31.1%) 6 (35.3%) Nipple Involvement 0.304 Normal 62 (79.5%) 50 (82%) 12 (71%) Retracted 16 (20.5%) 11 (18%) 05 (29%) Gross Borders 0.396 Circumscribed 26 (33.3%) 22 (36.1%) 4 (23.5%) Infiltrating 52 (66.7%) 39 (63.9%) 13 (76.5%) Focality 0.999 Unifocal 73 (93.6%) 57 (93.4%) 16 (94.1%) Multifocal 5 (6.4%) 4 (6.6%) 1 (5.9%) Histologic Type 0.771 IDC (NOS) 63 (80.8%) 50 (82.0%) 13 (76.5%) Metaplastic 9 (11.5%) 7 (11.5%) 2 (11.8%) Others 6 (7.7%) 4 (6.6%) 2 (11.8%) DCIS 0.999 Absent 62 (78.2%) 50 (82.0%) 12 (70.6%) Present 16 (21.8%) 11 (18.0%) 5 (29.4%) Necrosis 0.279 Absent 36 (46.2%) 26 (42.6%) 10 (58.8%) Present 42 (53.8%) 35 (57.4%) 7 (41.2%) Apocrine Differentiation 0.643 No 71 (91.0%) 56 (91.8%) 15 (88.2%) Yes 7 (9.0%) 5 (8.2%) 2 (11.8%) LVI 0.216 Absent 59 (75.6%) 44 (72.1%) 15 (88.2%) Present 19 (24.4%) 17 (27.9%) 2 (11.8%) MBR Grade 0.583 Grade 1 5 (6.4%) 3 (4.9%) 2 (11.8%) Grade 2 26 (33.3%) 21 (34.4%) 5 (29.4%) Grade 3 47 (60.3%) 37 (60.7%) 10 (58.8%) Ki 67 category (n=59) 0.002 ** Low Ki-67 (<10) 4 (6.8%) 0 4 (30.8%) High Ki-67 (≥10) 55 (93.2%) 46 (100.0%) 9 (69.2%) Ki 67 Median (min-max) 50 (5-92) 60.0 (10-92) 10.0 (5-70) 0.001 *** P-value by Chi-Square test (Fisher’s exact probability test). P-value on Ki 67 by Mann-Whitney U test. P-value <0.05 is statistically significant. Table 3: Distribution of TNM and clinical staging according to Androgen Receptor (AR) expression. Characteristic All cases (n=78) Androgen Receptor (AR) P-value Negative (n=61) Positive (n=17) T-tumor 0.149 T1 9 (11.5%) 8 (13.1%) 1 (5.9%) T2 47 (60.3%) 33 (54.1%) 14 (82.4%) T3 10 (12.8%) 10 (16.4%) 0 T4 12 (15.4%) 10 (16.4%) 2 (11.8%) N-node 0.573 NX 12 (15.4%) 9 (14.8%) 3 (17.6%) N0 41 (52.6%) 30 (48.2%) 11 (64.7%) N1 12 (15.4%) 10 (16.4%) 2 (11.8%) N2 6 (7.7%) 5 (8.2%) 1 (5.9%) N3 7 (9.0%) 7 (11.5%) 0 M-metastasis 0.682 M0 68 (87.2%) 54 (88.5%) 14 (82.4%) M1 10 (12.8%) 7 (11.5%) 3 (17.6%) Clinical staging 0.536 Stage I 6 (7.7%) 5 (8.2%) 1 (5.9%) Stage II 42 (53.8%) 31 (50.8%) 11 (64.7%) Stage III 19 (24.4%) 17 (27.9%) 2 (11.8%) Stage IV 11 (14.1%) 8 (13.1%) 3 (17.6%) Recurrence 0.211 No 58 (74.4%) 43 (70.5%) 15 (88.2%) Yes 20 (25.6%) 18 (29.5%) 2 (11.8%) Organ Involved on Recurrence 0.735 None 59 (75.6%) 44 (72.1%) 15 (88.2%) Brain 1 (1.3%) 1 (1.6%) 0 Bone 3 (3.8%) 2 (3.3%) 1 (5.9%) Lungs 6 (7.7%) 6 (9.8%) 0 Contralateral Breast 2 (2.6%) 2 (3.3%) 0 ≥2 Organs 6 (7.7%) 5 (8.2%) 1 (5.9%) Local recurrence 1 (1.3%) 1 (1.6%) 0 P-value by Chi-Square test (Fisher’s exact probability test). P-value <0.05 is statistically significant. Table 4: Distribution of swelling size and tumor size according to Androgen Receptor (AR) expression. Characteristic All cases (n=78) Androgen Receptor (AR) P-value Negative (n=61) Positive (n=17) Swelling size (C/F) 4.75 (1.0 – 20.0) 5.00 (1.0 – 20.0) 4.00 (2.0 – 10.0) 0.770 Median (min – max) ≤ 2 cm > 2 - ≤ 5 cm > 5 cm 12 (15.4%) 37 (47.4%) 29 (37.2%) 09 (14.8%) 30 (49.2%) 22 (36.1%) 03 (17.6%) 07 (41.2%) 07 (41.2%) 0.841 Tumor size Median (min – max) 3.75 (0.6 – 17.0) 4.00 (1.0 – 17.0) 3.50 (0.6 – 10.0) 0.623 ≤ 2 cm > 2 - ≤ 5 cm > 5 cm 10 (12.8%) 48 (61.5%) 20 (25.6%) 09 (14.8%) 33 (54.1%) 19 (31.1%) 01 (5.9%) 15 (88.2%) 01 (5.9%) 0.036 * P-values by Mann-Whitney U test. P-value<0.05 is statistically significant. Table 5: Disease-free survival and overall survival according to Androgen Receptor (AR) expression. Characteristic All cases(n=51) Androgen Receptor (AR) P-value Negative(n=40) Positive (n=11) Disease free survival (months) 28.6 (24.8-32.4) 26.7 (22.3-31.0) 35.6 (29.9-41.1) 0.091 Mean (95% CI) Overall Survival (months) 39.2 (29.0-48.5) 36.2(26.6- 45.8) 37.5 (32.3-40.7) 0.119 Mean (95% CI) P-values by Generalized Wilcoxon p test. P-value < 0.05 is statistically significant. Table 6: Cox regression analysis of Ki-67 as a predictor of disease-free survival in the study group . Ki-67 category HR 95%CI HR P-value Low (<10.0) 1.0 -- 0.037 * High (≥10.0) 1.86 1.12 – 2.81 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 18 Nov, 2025 Reviews received at journal 01 Oct, 2025 Reviewers agreed at journal 25 Sep, 2025 Reviews received at journal 05 Sep, 2025 Reviewers agreed at journal 03 Sep, 2025 Reviewers invited by journal 03 Sep, 2025 Editor assigned by journal 03 Jul, 2025 Editor invited by journal 01 Jul, 2025 Submission checks completed at journal 01 Jul, 2025 First submitted to journal 01 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6927480","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":510820876,"identity":"ad28ff14-1da7-4900-8798-f91ccaa1f56c","order_by":0,"name":"Shubham Varshney","email":"","orcid":"","institution":"Kasturba medical college, Manipal Academy of Higher Education","correspondingAuthor":false,"prefix":"","firstName":"Shubham","middleName":"","lastName":"Varshney","suffix":""},{"id":510820877,"identity":"7147252f-5288-40c5-b0e3-4b330dbbe9bd","order_by":1,"name":"Deepa HC","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA60lEQVRIiWNgGAWjYDCCA1CSH0QlMDDIACkD4rRINkC08BCvxQDCIEIL3/HmYw9+MNyRN752+NmDhzvseBjYm7dJ4NMieeZYumEPwzPDbbfTzA0SzyTzMPAcK8OrxeBGjpkED8PhBLPbCWYSiW3MPAwSQBG8Wu6//yb5B6jFeHb6N6CWeh4G+TcEtNzgYZMG2WIgnQOy5TDQFh78WiTPpJkbyxgcNpxxO6dMIvHMcR42nrRiC3xa+I4ffvbwTcVhef7Z6dskf+6oluNnP7zxBj4tQMCGiAjGBjCXIEBSA9IyCkbBKBgFowAdAAA3oEjYv20kQQAAAABJRU5ErkJggg==","orcid":"","institution":"Kasturba medical college, Manipal Academy of Higher Education","correspondingAuthor":true,"prefix":"","firstName":"Deepa","middleName":"","lastName":"HC","suffix":""},{"id":510820878,"identity":"db751061-61d4-4bd6-b6b0-16f0a063ff80","order_by":2,"name":"Padmapriya Jaiprakash","email":"","orcid":"","institution":"Kasturba medical college, Manipal Academy of Higher Education","correspondingAuthor":false,"prefix":"","firstName":"Padmapriya","middleName":"","lastName":"Jaiprakash","suffix":""},{"id":510820879,"identity":"5bb3e465-4495-4e57-ac71-ce4bb1f0cb46","order_by":3,"name":"Shivani Gupta","email":"","orcid":"","institution":"Ashok Pathology and Research centre","correspondingAuthor":false,"prefix":"","firstName":"Shivani","middleName":"","lastName":"Gupta","suffix":""}],"badges":[],"createdAt":"2025-06-19 04:53:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6927480/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6927480/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90910391,"identity":"a06ed15b-0655-473c-b2e3-dc24791009ad","added_by":"auto","created_at":"2025-09-09 13:37:49","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":800761,"visible":true,"origin":"","legend":"\u003cp\u003eVarious histological subtypes of TNBC. (a)Infiltrating ductal carcinoma – Microphotograph showing tumor cells with high N:C ratio, coarse chromatin, irregular nuclear contour and moderate eosinophilic cytoplasm and numerous mitotic figures – 200x, H \u0026amp; E. (b)Medullary carcinoma – Microphotograph showing tumor cells arranged in syncytium surrounded by dense lymphoplasmacytic infiltrate – 100x, H \u0026amp; E. (c)Microphotograph showing well differentiated neoplastic squamous cells arranged in sheets, and nests with moderate pleomorphism and abundant eosinophilic cytoplasm – 100x, H\u0026amp;E. (d)Metaplastic carcinoma with mesenchymal differentiation-Microphotograph showing chondroid and osseous differentiation – 100x, H\u0026amp;E. (e)IDC with apocrine differentiation – Tumor cells arranged in sheets and nests with enlarged nuclei and prominent nucleoli with abundant foamy cytoplasm (Type B cells)- 100x, H\u0026amp;E (Inset – 400x, H\u0026amp;E). (f)Secretory Carcinoma: Tumor cells arranged in diffuse sheets with individual polygonal cells having granular eosinophilic to foamy cytoplasm-100x, H\u0026amp;E (Inset – 200X, H\u0026amp;E). (g)AR nuclear immunoexpression (inset) in high grade infiltrating ductal carcinoma in \u0026gt;1% of the cells (IHC, Dako – 200x)\u003c/p\u003e","description":"","filename":"FIg1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6927480/v1/c060b9e9b314de6aa2aad132.jpg"},{"id":90909372,"identity":"ae9224fe-a6fb-46f5-90a3-3a5198f57f97","added_by":"auto","created_at":"2025-09-09 13:29:49","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":139056,"visible":true,"origin":"","legend":"\u003cp\u003ea. Kaplan Meier Curve showing Hazard Function for Ki-67 Category.\u003c/p\u003e\n\u003cp\u003eb. Kaplan Meier curve showing disease-free survival (DFS) for AR positive and AR negative groups\u003c/p\u003e\n\u003cp\u003ec. Kaplan Meier curve showing a reduced overall survival (OS) for the AR negative group (blue line) as compared to the AR positive group (green line).\u003c/p\u003e","description":"","filename":"Fig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6927480/v1/2b59b7c79e501d6068a83253.jpg"},{"id":90914298,"identity":"807d5380-fc74-4eff-a828-1392a6d722ce","added_by":"auto","created_at":"2025-09-09 14:01:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2386914,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6927480/v1/ce131e2b-ca16-454f-ad7f-643788e55e60.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exploring the Role of Androgen Receptor Expression in Triple-Negative Breast Cancer: Implications for Targeted Therapy","fulltext":[{"header":"1. BACKGROUND","content":"\u003cp\u003eBreast cancer is the most frequent cancer in women and the fifth leading cause of cancer death worldwide (1,2). Triple-negative breast cancers (TNBC) alone account for approximately 12 to 24% of the cases (3). TNBC is defined as \u0026ldquo;absence of expression for estrogen receptor (ER) and progesterone receptor (PR) by immunohistochemistry (IHC), absence of over-expression for human epidermal growth factor receptor factor Her 2/neu (HER 2) by IHC and absence of amplification of HER2 by Fluorescent in situ hybridization (FISH)\u0026rdquo;(4).\u003c/p\u003e\u003cp\u003eTNBC is an aggressive histological subtype that more commonly affects young females and has a higher histological grade and more advanced disease. The prevalence of TNBC is found to be higher in India as compared to Western countries (5). The overall prevalence of TNBC in northern, southern, eastern \u0026amp; western regions of India was 28%, 34%, 30%, \u0026amp; 31%, respectively, and an overall combined prevalence of 31% in India (5).\u003c/p\u003e\u003cp\u003eThe histologic features of TNBC are infiltrating ductal carcinoma- not otherwise specified (IDC-NOS) grade 3 with high mitotic rate, pushing margin of invasion, geographic tumor necrosis, lymphocytic stromal response, solid-/sheet-like or ribbon-like growth pattern, large central zone of fibrosis/necrosis, metaplastic differentiation, myoepithelial differentiation, salivary gland differentiation, apocrine differentiation, secretory differentiation (6).\u003c/p\u003e\u003cp\u003eOwing to their aggressive behaviour, the rate of distant recurrences is more as compared to local recurrence. Metastatic TNBCs have more propensity to involve viscera such as lungs and brain and less propensity towards bones as in contrast to their ER positive counterpart. Most patients will present with multiple site involvement (7).\u003c/p\u003e\u003cp\u003eTNBC is a heterogeneous disease comprising different biological subtypes recognized by different gene expression profiling studies (8,9). This heterogeneity explains the need to develop new therapeutic strategies and alternatives to the currently used drugs (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Thus, androgen receptor (AR) is emerging as a new marker and a potential new therapeutic target in the treatment of breast cancer (9).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFour major classifications of TNBC and promising subtype-directed personalized therapy\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBASAL-LIKE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMESENCHYMAL\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eIMMUNE\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLUMINAL\u003c/p\u003e\u003cp\u003eANDROGEN\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBiologic pathway\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDNA damage response\u003c/p\u003e\u003cp\u003eCell cycle\u003c/p\u003e\u003cp\u003epathway\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEMT, Wnt and Notch signaling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eImmune cell signaling\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eLuminal androgen signaling\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTargeted therapy\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePlatinum-based PARP inhibitor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMET inhibitor FGFR inhibitor\u003c/p\u003e\u003cp\u003emTOR inhibitor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eImmune checkpoint\u003c/p\u003e\u003cp\u003einhibitor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAndrogen blockade\u003c/p\u003e\u003cp\u003ePIK3CA\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe mainstay of treatment for TNBC is cytotoxic chemotherapy. Despite having a heterogeneous nature and no known targetable biomarker, TNBC has higher response rates to neoadjuvant chemotherapy compared to other breast cancer subtypes; this phenomenon is known as TNBC paradox (10). AR is a member of the steroid receptor family of ligand-activated nuclear transcription factors, which have a similar structure as that of other steroid hormones like estrogen, progesterone, glucocorticoid, and thyroid hormone receptors (11). It links a transcription factor that controls specific genes involved in different cellular processes; by either stimulating or suppressing both cell proliferation and apoptosis, depending on the concurrent signaling pathways activated (12).\u003c/p\u003e\u003cp\u003eThe median survival of TNBC patients with metastasis is only 12\u0026ndash;18 months compared to 5 years for patients with metastatic HER-2 positive breast cancer, highlighting the need for more effective systemic therapies for this group of patients (13). Furthermore, for metastatic TNBC, median progression-free survival after first-line chemotherapy is only 3\u0026ndash;4 months, highlighting the need for the development of new therapies for the treatment of metastatic TNBC.\u003c/p\u003e\u003cp\u003eLoibl and colleagues reported that AR-negative tumors were more likely to achieve a pathologic complete response (pCR) with neoadjuvant docetaxel/ doxorubicin/ cyclophosphamide chemotherapy than AR-positive tumors. However, despite their decreased responsiveness to neo-adjuvant chemotherapy (NAC), AR-positive tumors had significantly better DFS and OS than AR-negative tumors. Similar findings were reported by Masuda et al with a decreased pCR rate among the luminal androgen receptor (LAR) subtype (10%) as compared to all TNBC (28%)(14).\u003c/p\u003e\u003cp\u003eThere has been enough evidence in the literature regarding androgen receptor (AR) testing as a biomarker and a therapeutic target in TNBC, but however, there is a paucity of such studies in India. Hence, this study was undertaken to evaluate the expression of AR by immunohistochemistry in TNBC, and to study its relation to potential prognostically significant factors like tumor size and site, laterality, histological subtype, tumor grade and stage, necrosis, LVI, DCIS and Ki67 index and also to calculate overall survival (OS) \u0026amp; disease-free survival (DFS) in AR-positive and AR-negative cases.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cp\u003eIn this retrospective study, 78 female breast lump resection cases of TNBC (including Her2neu 1\u0026thinsp;+\u0026thinsp;and 2\u0026thinsp;+\u0026thinsp;with negative FISH) without prior neoadjuvant therapy between January 2016 and December 2017 were studied for Androgen receptor (AR) status, which was evaluated by immunohistochemistry (Dako, Denmark A/S, Glostrup, Denmark) on TMA blocks (Institutional Ethics Committee Number -IEC 454/2018).\u003c/p\u003e\u003cp\u003eA threshold to define AR positivity was defined based on a study done by Astvatsaturyan K et al. (4), where AR immunoreactivity in at least 1% of tumor cell nuclei was considered the most appropriate threshold. The patients were further divided into two groups: AR Positive \u0026amp; AR Negative. Slides from already proven cases of BPH were taken as external positive control, and normal ductal lining epithelial cells were taken as internal positive control to ensure the quality of the antibody and technique.\u003c/p\u003e\u003cp\u003eOf the total 78 cases, only 59 cases had the Ki-67 index available. These cases were further categorized into Low Ki-67 expression (\u0026lt;\u0026thinsp;10) and High Ki-67 expression (\u0026ge;\u0026thinsp;10), according to Keam et al (15).\u003c/p\u003e\u003cp\u003eOf the total 78 patients, 51 followed up in the Medical Oncology department at an interval of 3 months during each hospital visit. These patients, after definitive diagnosis and surgery, were treated with at least 4 cycles of Doxorubicin and Cyclophosphamide every 3 weeks over 12 weeks, followed by Paclitaxel again weekly over 12 weeks. Radiotherapy was given in patients with T3 stage, node positivity, and patients who underwent BCS.\u003c/p\u003e\u003cp\u003eDisease outcome was defined in terms of disease-free survival (DFS), overall survival (OS), recurrence, and lost to follow-up. Disease-free survival (DFS) was defined as the time from the date of surgery to the date of first recurrence, metastasis, or mortality associated with breast cancer. Overall survival (OS) was defined as the period from the date of surgery to the date of mortality associated with breast cancer or the last follow-up time. Both OS and DFS were correlated with the immunohistochemical expression of AR.\u003c/p\u003e\u003cp\u003eThe entire data was statistically analyzed using Statistical Package for Social Sciences (SPSS version 20.0, IBM Corporation, USA) for MS Windows. Categorical variables were represented as frequency table and Continuous variables as Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD/ Median (Min, Max). The inter-group statistical comparison of the distribution of categorical variables was tested using the Chi-Square test or Fisher\u0026rsquo;s exact probability test; continuous variables were done using the independent sample t-test, and non-normally distributed continuous variables were done using the Mann-Whitney U test. In the entire study, the p-values less than 0.05 were statistically significant. Association with survival was analysed by the Kaplan-Meier plot and log-rank test. The Cox proportional hazard model was used to compute the univariate hazard ratio for the Ki-67% index with 95% confidence intervals (95%CI).\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1\u003c/strong\u003e. \u003cstrong\u003ePatient overview\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e78\u0026nbsp;female\u0026nbsp;patients\u0026nbsp;with\u0026nbsp;TNBCs were identified.\u0026nbsp;The various clinicopathological parameters are summarised in Table 2 and Table 3.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2. Prevalence of Androgen receptor (AR)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAR expression was positive in 17/78 (22%)\u0026nbsp;cases and was negative in 61/78(78%) TNBC cases, with a cutoff of staining of \u0026gt;1%\u0026nbsp;cells,\u0026nbsp;irrespective of the\u0026nbsp;staining intensity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3. Clinical features\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTNBC patient\u0026apos;s ages ranged from 22-78 years, with a median of 51 years.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTNBC involved mostly right breast with 43 (55.1%) cases, with 8/17 (47.1%) AR-positive TNBC and 35 (57.4%) AR negative TNBC.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe upper outer quadrant (UOQ) was most involved; with 32/61 (52.5%) cases in AR negative TNBCs and 8/17 (47.1%) in AR positive TNBCs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOut of 78 TNBC patients, 47 (60.3%) presented with axillary swelling, out of which 36 (59%) were AR-negative.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOverall, 25 cases (32.1%) presented with skin involvement, but as compared to AR negative cases, 19 (31.1%) AR positive showed slightly more involvement with 6/17 cases (35.3%). AR-positive tumors showed more nipple involvement.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOn\u0026nbsp;mammography,\u0026nbsp;of\u0026nbsp;7\u0026nbsp;BI-RADS\u0026nbsp;assessment\u0026nbsp;categories,\u0026nbsp;2\u0026nbsp;groups were made: 0-3 (benign) and another 4-6 (suspicious/malignant). Of the total 78 cases, only 7 cases were categorized as benign category, out of which 2 (11.8%) were AR-positive\u0026nbsp;and 5 were AR-negative (8.2%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMetastasis was seen in only 10 (12.8%) cases out of which 7 (11.5%) were AR negative and 3 (17.6%) were AR positive. The most commonly involved organ was the lung in 5/10 (8.2%) cases, all being AR negative. The distribution of organ involvement among AR-positive and AR-negative\u0026nbsp;cases\u0026nbsp;showed\u0026nbsp;statistical\u0026nbsp;significance\u0026nbsp;(p= 0.026).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4. Gross and microscopy:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMost of the TNBC tumors showed infiltrating borders 52/78 (66.7%). Out of which, 22/61 (36.1%) of AR-negative tumors showed circumscription, while only 4/17 (23.5%) of AR-positive tumors showed circumscribed borders.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOut of 78 TNBCs, only 5 (6.4%) showed multifocality, with 4/61 (6.6%) being AR-negative and only a single case in the AR-positive group.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe most common histologic subtype seen was infiltrating duct carcinoma (IDC)- NOS (63 cases-80.8%) followed by metaplastic carcinoma (9 cases- 11.1%); others were one case each of secretory carcinoma, invasive apocrine carcinoma, bilateral lobular carcinoma and 3 cases of IDC with medullary features (fig 1). Interestingly, out of 9 cases of metaplastic tumors, 2 showed positivity for the AR\u0026nbsp;receptor.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn most of the TNBC tumors, DCIS was absent, and only 16 cases showed DCIS, with AR-positive tumors showing more DCIS component 5/17 (29.4%) as compared to the AR-negative\u0026nbsp;group, wherein\u0026nbsp;only\u0026nbsp;18% of the tumors\u0026nbsp;showed DCIS component.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNecrosis was a feature seen in 53.8% (42/78) TNBC tumors, with AR-negative tumors showing 57.4% (35/61) tumor necrosis as compared to 41.2% (7/17) AR-positive tumors. A total of 7 cases showed apocrine differentiation, of which only 11.8% (2/17) were AR-positive, and the remaining 5, which is 8.2%, were AR-negative tumors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA total of 19 cases (24.4%) showed LVI, out of which 17 (27.9%) were AR-negative and 2 (11.8%) were AR-positive.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost of the TNBC tumors, 47/78 (60.3%), showed MBR grade 3 with similar percentages, 60.7% and 58.8%, seen in AR-negative and AR-positive groups, respectively. Only 2 cases (11.8%) AR-positive and 3 (4.9%) AR-negative tumors show MBR Grade 1.\u003c/p\u003e\n\u003cp\u003eIn the present study, out of 59 available Ki -67 cases, only 4 cases showed a low Ki-67 index, and all showed AR Positivity. All the AR negative cases (100%) showed a high Ki-67 index (\u0026ge; 10), with only 9 (69.2%) cases being AR-positive. This difference was\u0026nbsp;statistically\u0026nbsp;significant\u0026nbsp;with a p-value\u0026nbsp;(\u0026lt;0.05). Also, the median Ki-67 was 60% in AR negative tumors, which was also significantly higher as compared to AR-positive\u0026nbsp;tumors with\u0026nbsp;a\u0026nbsp;median of only 10% (fig 2-A).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;3.5.\u003c/strong\u003e \u003cstrong\u003ePathological (p) TNM Staging and Clinical Staging:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no statistical difference between the two groups when the patients were categorized into different stages based on tumor size (T), number of nodes involved (N), and local or distant metastasis (M) [p value = \u0026gt;0.05].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.6.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eRecurrence and Organ Involved in Recurrence:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, around 25% (20/78) of subjects presented with recurrence out of which 18 (29.5%) were AR negative and only 2 (11.8%) cases were AR positive. The most common organ involved in recurrence was the lung (6/18), followed by multi-organ (\u0026ge;2 organs) involvement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.7.\u003c/strong\u003e \u003cstrong\u003eSwelling size and tumor size:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor\u0026nbsp;this\u0026nbsp;study,\u0026nbsp;swelling\u0026nbsp;size\u0026nbsp;was\u0026nbsp;defined\u0026nbsp;as\u0026nbsp;the\u0026nbsp;clinically\u0026nbsp;measured\u0026nbsp;size\u0026nbsp;of\u0026nbsp;the\u0026nbsp;tumor at the time of presentation to the clinician. Tumor size was defined as the size of the tumor measured by pathologist at the time of grossing.\u003c/p\u003e\n\u003cp\u003eBut\u0026nbsp;when divided into 3 groups, AR-positive tumors were associated with smaller tumor\u0026nbsp;size\u0026nbsp;as\u0026nbsp;compared to AR-negative tumors showing statistical significance (p = 0.03) (table 4)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.8. Disease-free survival and overall survival:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean DFS for 51 TNBC cases was 28.6 months, which was higher in AR-positive TNBC (35.6 months) as compared to AR-negative TNBC (26.7 months) but was statistically non-significant (p = 0.091). The median overall DFS was 31 months, and for AR negative, it was 28 months.\u003c/p\u003e\n\u003cp\u003eThe mean OS for a total of 51 follow-up cases was 39.2 months. The mean OS for the AR-positive group was slightly higher at 37.5 months versus 36.2 months for the AR-negative group but with a non-significant p-value. The median overall OS was 38 months, and for the AR negative group, it was 31 months. Median OS and DFS for the AR-positive group could not be computed as the percentage of censored observation was very high.\u003c/p\u003e\n\u003cp\u003eThe Kaplan Meier curve for DFS \u0026amp; OS with AR status shows a trend that depicts a higher OS \u0026amp; DFS for AR-positive TNBCs when compared to AR-negative TNBCs but was not statistically significant owing to the small study population (table 5 and 6) (fig 2- B and C).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eAlthough having the reputation of being an aggressive form of breast cancer around 10 (12.8%) cases in the current study presented with distant metastasis. Out of 10, 7 belonged to the AR negative category, and 3 belonged to the AR positive category. The majority of metastasis was seen in the lungs, which was similar to the study done by Zakaria et al. (16), which also showed 25.9% (20/77) cases metastasizing to the lungs.\u003c/p\u003e\u003cp\u003eIn the current study, 76.5% of AR-positive tumors showed infiltrating borders as compared to 63.9% of AR-negative tumors. This was in concordance with a study done by Thike et al. (17) and colleagues, which also demonstrated infiltrating borders (p\u0026thinsp;=\u0026thinsp;0.032) in AR-expressing TNBCs.\u003c/p\u003e\u003cp\u003eIn a study done by Bae et al. (18), around 6.5% of AR-negative tumors showed multifocality, which was similar to the present study (6.6%). Only 1 case in the AR-positive group showed multifocality in both studies.\u003c/p\u003e\u003cp\u003eAlmost 54% of TNBC tumors presented with necrosis and, out of which 84% belonged to the AR-negative group \u0026amp; only 16% belonged to the AR-positive group, implying that AR expression in TNBC tumors indicates a good prognosis.\u003c/p\u003e\u003cp\u003eNone of the previous studies could establish an association between AR expression in TNBC\u003c/p\u003e\u003cp\u003eand lymphovascular invasion (LVI). Nevertheless, studies done by Bae et al., (18) Thike et al.(17), and Asano et al.(19), showed LVI being more frequently present(86%, 65%, and 80% respectively) in the AR negative group as compared to AR positive group, which was similar to the present study findings(90%) and is a marker of better prognosis\u003c/p\u003e\u003cp\u003eVery few studies have compared AR expression with DCIS. In a study done by Bae et al. (18), AR-positive cancers were more likely to have a DCIS component (p-value\u0026thinsp;=\u0026thinsp;0.001) than AR-negative tumors. In another study by Thike et al. (17), AR-positive tumors showed more DCIS components as compared to AR-negative tumors. In the current study also, the DCIS component was more expressed in the AR positive group (29.4%) as compared to the AR negative group (18%).\u003c/p\u003e\u003cp\u003eThough TNBCs generally show a high MBR grade, AR-positive tumors have been associated with a low or intermediate histologic grade (20). Few studies could establish the association (16,17,21,22,23) while others could not (4,19,24,25,26). We also did not find any association between MBR grade and AR expression.\u003c/p\u003e\u003cp\u003eIn the present study, we found that AR-positive tumors are significantly associated with smaller tumor sizes as compared to AR-negative tumors. This finding was consistent with most of the studies done to date (19,21,27).\u003c/p\u003e\u003cp\u003eSeveral studies have shown that AR-positive immunostaining is associated with a lower mitotic index (4,24,28). In the existing study also, AR expression was significantly associated with a low Ki-67 index, while its loss of expression was associated with a high Ki-67 (\u0026ge;\u0026thinsp;10) index. It was also seen that the median Ki-67 was 60% in AR-negative tumors, which was significantly higher as compared to AR-positive tumors, which were 10%.\u003c/p\u003e\u003cp\u003eIn the current study, around 82% of AR-positive tumors presented with T2 stage as compared to 54.1% in AR-negative tumors. Also, around 65% of AR-positive tumors showed no metastasis to lymph nodes, which was in conjugation with the studies done by Zakaria et al(16) and Xuan et al. (26) Similarly in clinical staging 64.7% AR expressing tumors belonged to Stage II as compared to 50.8% in AR negative tumors; which again implies that AR positivity in TNBC is associated with lower pathological \u0026amp; clinical stage.\u003c/p\u003e\u003cp\u003eBased on analysis done by Thike et al. (17) and Luo et al. (29), AR-negative tumors are significantly associated with recurrences and distant metastasis. In the current study also, around 30% of AR-negative patients had recurrence as compared to 11.8% in AR-positive patients. Moreover, as far as the distant metastasis pattern of TNBC is concerned, previous studies reported a higher incidence of visceral metastasis as compared to bone metastasis, favoring a hematogenous spread in TNBC patients (30,31). Consistently, our present study revealed that overall lung metastasis (7.7%) was the most frequent while brain metastasis (1.3%) was the least frequent, and bone metastasis was relatively lower (3.8%).\u003c/p\u003e\u003cp\u003eWe found that OS and DFS for AR-positive patients were better as compared to AR-negative patients but were non-significant. AR expression overall had a good effect on survival in the present study, and patients with AR-positive TNBC survived longer, with lower recurrence than those with AR-negative TNBC. In a meta-analysis done by Wang C et al. (32), which included 2826 TNBC patients, AR positivity showed no effect on OS but was associated with a lower risk of disease recurrence. Another study done by McGhan et al. (33) and Mehrdad et al. (34) showed that OS was similar between AR-positive and AR-negative patients. Alternatively, He et al. (35) demonstrated that the expression of AR is a favorable prognostic factor in terms of both OS (HR 0.34, p\u0026thinsp;=\u0026thinsp;0.011) and DFS (HR 0.40, p\u0026thinsp;=\u0026thinsp;0.008). A recent systematic meta-analysis of 19 studies consisting of 7693 patients displayed that the expression of AR is associated with improved OS \u0026amp; DFS regardless of ER expression, with approximately a doubling of OS at 3 and 5 years.\u003c/p\u003e\u003cp\u003eAlso, in the present study, on univariate analysis of Ki-67 with DFS, we found that the high Ki-67 index predicts almost two times higher incidence of lower DFS as compared to the low Ki-67 index group. Thus, Ki-67 can be further used to divide TNBC into two groups and can also act as a prognostic indicator. These findings were in concordance with the studies done by Keam et al (15) and Ricciardi et al (36), both of which demonstrated that high Ki-67 index levels are independent predictors of OS and DFS in TNBC tumors and are associated with a more aggressive clinico- pathological features despite a higher pathologic complete response (pCR) rate.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eIt is important to include an assessment of AR as a part of routine evaluations of at least TNBC patients and, preferably, all breast carcinomas. From this study, we can support the value of AR expression and can also rely on AR expression as a prognostic factor for disease outcomes in TNBC patients. Also, AR can be used as a predictive factor for new targeted treatment in this aggressive sub-type of breast cancer. Thus, both AR \u0026amp; Ki-67 status together might be useful prognostic markers in TNBC in order to sub-classify the risk of these patients.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eTriple-negative breast cancers (TNBC)\u003c/p\u003e\n\u003cp\u003eAndrogen receptor (AR)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eoverall survival (OS)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003edisease-free survival (DFS)\u003c/p\u003e\n\u003cp\u003eDuctal carcinoma in situ (DCIS)\u003c/p\u003e\n\u003cp\u003eLymphovascular invasion (LVI)\u003c/p\u003e\n\u003cp\u003eModified Bloom Richardson (MBR)\u003c/p\u003e\n\u003cp\u003eEstrogen receptor (ER)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProgesterone receptor (PR)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHuman epidermal growth factor receptor factor Her 2/neu (HER 2)\u003c/p\u003e\n\u003cp\u003eImmunohistochemistry (IHC)\u003c/p\u003e\n\u003cp\u003eFluorescent in situ hybridization (FISH)\u003c/p\u003e\n\u003cp\u003ePathologic complete response (pCR)\u003c/p\u003e\n\u003cp\u003eInfiltrating ductal carcinoma- not otherwise specified (IDC -NOS)\u003c/p\u003e\n\u003cp\u003eNeo- adjuvant chemotherapy (NAC)\u003c/p\u003e\n\u003cp\u003eLuminal androgen receptor (LAR)\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003eEthics approval and consent to participate: Kasturba Medical College and Kasturba Hospital Institutional Ethics Committee Number -IEC 454/2018, adhered to declaration of Helsinki, need for consent to participate was waived by institutional review board.\u003c/li\u003e\n \u003cli\u003eConsent for publication: NA\u003c/li\u003e\n \u003cli\u003eAvailability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/li\u003e\n \u003cli\u003eCompeting interests: The authors have no relevant financial or non-financial interests to disclose.\u003c/li\u003e\n \u003cli\u003eFunding: The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/li\u003e\n \u003cli\u003eAuthors contribution: All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [full name], [full name] and [full name]. The first draft of the manuscript was written by [full name] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/li\u003e\n \u003cli\u003eAcknowledgements: NIL\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBoyle P. Triple-negative breast cancer: Epidemiological considerations and recommendations. Ann Oncol. 2012;23(SUPPL. 6):8\u0026ndash;13.\u003c/li\u003e\n\u003cli\u003eIarc. IA for R on CWHO. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. Globocan. 2012; v1.0\u003c/li\u003e\n\u003cli\u003eSchmadeka R, Harmon BE, Singh M. Triple-negative breast carcinoma: Current and emerging concepts. Am J Clin Pathol. 2014;141(4):462\u0026ndash;77.\u003c/li\u003e\n\u003cli\u003eAstvatsaturyan K, Yue Y, Walts AE, Bose S. Androgen receptor positive triple negative breast cancer: Clinicopathologic, prognostic, and predictive features. PLoS One. 2018 Jun 1;13(6):1\u0026ndash;16.\u003c/li\u003e\n\u003cli\u003eSandhu GS, Erqou S, Patterson H, Mathew A. Prevalence of Triple-Negative Breast Cancer in India: Systematic Review and Meta-Analysis. J Glob Oncol. 2016;2(6):412\u0026ndash;21.\u003c/li\u003e\n\u003cli\u003ePutti TC, Abd El-Rehim DM, Rakha EA, Paish CE, Lee AHS, Pinder SE, et al. Estrogen receptor-negative breast carcinomas: A review of morphology and immunophenotypical analysis. Mod Pathol. 2005;18(1):26\u0026ndash;35.\u003c/li\u003e\n\u003cli\u003eDent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, et al. Triple-negative breast cancer: Clinical features and patterns of recurrence. Clin Cancer Res. 2007;13(15):4429\u0026ndash;34\u003c/li\u003e\n\u003cli\u003eAhn SG, Kim SJ, Kim C, Jeong J. Molecular classification of triple-negative breast cancer. J Breast Cancer. 2016;19(3):223\u0026ndash;30.\u003c/li\u003e\n\u003cli\u003eBianchini G, Balko JM, Mayer IA, Sanders ME, Gianni L. Triple-negative breast cancer: Challenges and opportunities of a heterogeneous disease. Nat Rev Clin Oncol. 2016;13(11):674\u0026ndash;90. \u003c/li\u003e\n\u003cli\u003eCarey LA, Dees EC, Sawyer L, Gatti L, Moore DT, Collichio F, et al. The triple negative paradox: Primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2007;13(8):2329\u0026ndash;34.\u003c/li\u003e\n\u003cli\u003eYu Q, Niu Y, Liu N, Zhang JZ, Liu TJ, Zhang RJ, et al. Expression of androgen receptor in breast cancer and its significance as a prognostic factor. Ann Oncol. 2011;22(6):1288\u0026ndash;94.\u003c/li\u003e\n\u003cli\u003eGerratana L, Basile D, Buono G, Placido S De, Giuliano M, Minichillo S, et al. Androgen receptor in triple negative breast cancer : A potential target for the targetless subtype. Cancer Treat Rev. 2018;68(April):102\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eSwain SM, Baselga J, Kim SB, Ro J, Semiglazov V, Campone M, et al. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N Engl J Med. 2015 Feb 19;372(8):724-34.\u003c/li\u003e\n\u003cli\u003eMasuda H, Baggerly KA, Wang Y, Zhang Y, Gonzalez-Angulo AM, Meric- Bernstam F, et al. Differential response to neoadjuvant chemotherapy among 7 triple-negative breast cancer molecular subtypes. Clin Cancer Res. 2013 Oct 1;19(19):5533-40. \u003c/li\u003e\n\u003cli\u003eKeam B, Im SA, Lee KH, Han SW, Oh DY, Kim JH, et al. Ki-67 can be used for further classification of triple negative breast cancer into two subtypes with different response and prognosis. Breast Cancer Res. 2011;13(2).\u003c/li\u003e\n\u003cli\u003eZakaria F, El-Mashad N, Mohamed D. Androgen receptor expression as a prognostic and predictive marker in triple-negative breast cancer patients. Alexandria J Med [Internet]. 2016;52(2):131\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eThike AA, Chong LYZ, Cheok PY, Li HH, Yip GWC, Bay BH, et al. Loss of androgen receptor expression predicts early recurrence in triple-negative and basal-like breast cancer. Mod Pathol [Internet]. 2014;27(3):352\u0026ndash;60. \u003c/li\u003e\n\u003cli\u003eBae MS, Park SY, Song SE, Kim WH, Lee SH, Han W, et al. Heterogeneity of triple-negative breast cancer: mammographic, US, and MR imaging features according to androgen receptor expression. Eur Radiol. 2015;25(2):419\u0026ndash;27.\u003c/li\u003e\n\u003cli\u003eAsano Y, Kashiwagi S, Goto W, Tanaka S, Morisaki T, Takashima T, et al. Expression and clinical significance of androgen receptor in triple-negative breast cancer. Cancers (Basel). 2017;9(1):1\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eAgoff SN, Swanson PE, Linden H, Hawes SE, Lawton TJ. Androgen Receptor Expression in Estrogen Receptor-Negative Breast Cancer: Immunohistochemical, Clinical, and Prognostic Associations. Am J Clin Pathol. 2003;120(5):725\u0026ndash;31\u003c/li\u003e\n\u003cli\u003eFarag K, Elfarargy O, El Shorbagy S, Ahmed S, Harb O, Amin R, et al. Prevalence of androgen receptors expression in triple negative breast cancer patients and its correlation with clinicopathological criteria: Our institutes experience. J Clin Oncol. 2017;35(15_suppl):e12584\u0026ndash;e12584.\u003c/li\u003e\n\u003cli\u003eTang D, Xu S, Zhang Q, Zhao W. The expression and clinical significance of the androgen receptor and E-cadherin in triple-negative breast cancer. Med Oncol. 2012;29(2):526\u0026ndash;33.\u003c/li\u003e\n\u003cli\u003eAlshenawy HAS. Prevalence of androgen receptors in invasive breast carcinoma and its relation with estrogen receptor, progesterone receptor and Her2/neu expression. J Egypt Natl Canc Inst [Internet]. 2012;24(2):77\u0026ndash;83. \u003c/li\u003e\n\u003cli\u003eBae MS, Park SY, Song SE, Kim WH, Lee SH, Han W, et al. Heterogeneity of triple-negative breast cancer: mammographic, US, and MR imaging features according to androgen receptor expression. Eur Radiol. 2015;25(2):419\u0026ndash;27.\u003c/li\u003e\n\u003cli\u003eGiannos A, Filipits M, Zagouri F, Brandstetter A, Tsigginou A, Sotiropoulou M, et al. Expression of ARs in triple negative breast cancer tumors: A potential prognostic factor? Onco Targets Ther. 2015;8:1843\u0026ndash;7\u003c/li\u003e\n\u003cli\u003eLiu YX, Zhang KJ, Tang LL. Clinical significance of androgen receptor expression in triple negative breast cancer-an immunohistochemistry study. Oncol Lett. 2018;15(6):10008\u0026ndash;16.\u003c/li\u003e\n\u003cli\u003eYang WT, Dryden M, Broglio K, Gilcrease M, Dawood S, Dempsey PJ, et al. Mammographic features of triple receptor-negative primary breast cancers in young premenopausal women. Breast Cancer Res Treat. 2008;111(3):405\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eMrklić I, Pogorelić Z, Ćapkun V, Tomić SŽ. Expression of androgen receptors in triple negative breast carcinomas. Acta Histochem. 2013;115(4):344\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eLuo X, Shi YX, Li ZM JW. Expression and clinical significance of androgen receptor in triple negative breast cancer. China J Cancer. 2010;29(6):585\u0026ndash;90.\u003c/li\u003e\n\u003cli\u003eMoln\u0026aacute;r IA, Moln\u0026aacute;r B\u0026Aacute;, V\u0026iacute;zkeleti L, Fekete K, Tam\u0026aacute;s J, De\u0026aacute;k P, et al. Breast carcinoma subtypes show different patterns of metastatic behavior. Virchows Arch. 2017;470(3):275\u0026ndash;83.\u003c/li\u003e\n\u003cli\u003eYao Y, Chu Y, Xu B, Hu Q, Song Q. Risk factors for distant metastasis of patients with primary triple-negative breast cancer. Biosci Rep. 2019;39(6):1\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eWang C, Pan B, Zhu H, Zhou Y, Mao F, Lin Y, et al. Prognostic value of androgen receptor in triple negative breast cancer: A meta-analysis. Oncotarget. 2016;7(29):46482\u0026ndash;91.\u003c/li\u003e\n\u003cli\u003eMcGhan LJ, McCullough AE, Protheroe CA, Dueck AC, Lee JJ, Nunez- Nateras R, et al. Androgen receptor-positive triple negative breast cancer: A unique breast cancer subtype. Ann Surg Oncol. 2014 Feb;21(2):361-7. \u003c/li\u003e\n\u003cli\u003ePayandeh M, Shazad B, Madani SH, Ramezani M, Sadeghi M. Androgen receptor expression and its correlation with other risk factors in triple negative breast cancers: A report from Western Iran. Asian Pac J Cancer Prev. 2016;17(7):3321-4.\u003c/li\u003e\n\u003cli\u003eHe J, Peng R, Yuan Z, Wang S, Peng J, Lin G, et al. Prognostic value of androgen receptor expression in operable triple-negative breast cancer: A retrospective analysis based on a tissue microarray. Med Oncol. 2012 Jun;29(2):406-10.\u003c/li\u003e\n\u003cli\u003eRicciardi GRR, Adamo B, Ieni A, Licata L, Cardia R, Ferraro G, et al. Androgen receptor (AR), E-Cadherin, and Ki-67 as emerging targets and novel prognostic markers in triple-negative breast cancer (TNBC) patients. PLoS One. 2015;10(6):1\u0026ndash;11.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Four major classifications of TNBC and promising subtype-directed personalized therapy\u003c/strong\u003e \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"608\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBASAL-LIKE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMESENCHYMAL\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIMMUNE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLUMINAL\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eANDROGEN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBiologic\u0026nbsp;pathway\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eDNA\u0026nbsp;damage\u0026nbsp;response\u003c/p\u003e\n \u003cp\u003eCell\u0026nbsp;cycle\u003c/p\u003e\n \u003cp\u003epathway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eEMT, Wnt and\u0026nbsp;Notch\u0026nbsp;signaling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003eImmune cell\u0026nbsp;signaling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003eLuminal\u0026nbsp;androgen\u0026nbsp;signaling\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTargeted\u0026nbsp;therapy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003ePlatinum-based\u0026nbsp;PARP\u0026nbsp;inhibitor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 155px;\"\u003e\n \u003cp\u003eMET inhibitor FGFR inhibitor\u003c/p\u003e\n \u003cp\u003emTOR\u0026nbsp;inhibitor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003eImmune\u0026nbsp;checkpoint\u003c/p\u003e\n \u003cp\u003einhibitor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003eAndrogen\u0026nbsp;blockade\u003c/p\u003e\n \u003cp\u003ePIK3CA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Distribution of clinicopathological parameters according to Androgen Receptor (AR) expression.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll cases\u0026nbsp;(n=78)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 233px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAndrogen\u0026nbsp;Receptor\u0026nbsp;(AR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative\u0026nbsp;(n=61)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u0026nbsp;(n=17)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u0026nbsp;(years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;\u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e50.5 \u0026plusmn; 12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e50.2 \u0026plusmn; 12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e51.3 \u0026plusmn; 13.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.758\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMedian\u0026nbsp;(min \u0026ndash; max)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e51.0\u0026nbsp;(22 -\u0026nbsp;78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e51.0\u0026nbsp;(22 -\u0026nbsp;78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e53.0\u0026nbsp;(30 -\u0026nbsp;77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026le;35 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.400\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026gt;35\u0026nbsp;years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e69 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e55 (90.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e14 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLaterality\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eRight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e43 (55.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e35 (57.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e8 (47.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLeft\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e34 (43.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e26 (42.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e8 (47.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBilateral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTumor Site\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"7\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.862\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eUOQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e40 (51.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e32 (52.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e8 (47.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eUIQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e11 (14.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e9 (14.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLOQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e2 (2.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e2 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLIQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e4 (6.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eCentral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e3 (4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMulticentric\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e15 (19.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e11 (18.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e4 (23.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAxillary Swelling\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.783\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e31 (39.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e25 (41.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6 (35.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e47 (60.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e36 (59.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e11 (64.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMetastasis\u0026nbsp;at\u0026nbsp;Presentation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.682\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e68 (87.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e54 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e14 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e10 (12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrgan\u0026nbsp;Involved\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"7\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.026\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e68 (87.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e54 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e14 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBrain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e1 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLiver\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e2 (2.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eBone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e1 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLung\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026ge;\u0026nbsp;2\u0026nbsp;Organs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBI-RADS\u0026nbsp;Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.643\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e0 \u0026ndash; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e7 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e4 \u0026ndash; 6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e71 (91.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e56 (91.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e15 (88.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSkin\u0026nbsp;Involvement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.774\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e53 (67.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e42 (68.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e11 (64.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e25 (32.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e19 (31.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e6 (35.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNipple\u0026nbsp;Involvement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.304\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e62 (79.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e50 (82%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12 (71%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eRetracted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e16 (20.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e11 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e05 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGross\u0026nbsp;Borders\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eCircumscribed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e26 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e22 (36.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e4 (23.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eInfiltrating\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e52 (66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e39 (63.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e13 (76.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFocality\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eUnifocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e73 (93.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e57 (93.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e16 (94.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMultifocal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e4 (6.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistologic\u0026nbsp;Type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.771\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eIDC\u0026nbsp;(NOS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e63 (80.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e50 (82.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e13 (76.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eMetaplastic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e9 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e6 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e4 (6.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDCIS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e62 (78.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e50 (82.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12 (70.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e16 (21.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e11 (18.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5 (29.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNecrosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.279\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e36 (46.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e26 (42.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e10 (58.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e42 (53.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e35 (57.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e7 (41.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eApocrine\u0026nbsp;Differentiation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.643\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e71 (91.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e56 (91.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e15 (88.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e7 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLVI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.216\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eAbsent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e59 (75.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e44 (72.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e15 (88.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003ePresent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e19 (24.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e17 (27.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMBR\u0026nbsp;Grade\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.583\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eGrade\u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e5 (6.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e3 (4.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eGrade\u0026nbsp;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e26 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e21 (34.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e5 (29.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eGrade\u0026nbsp;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e47 (60.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e37 (60.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e10 (58.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKi\u0026nbsp;67\u0026nbsp;category\u0026nbsp;(n=59)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.002\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eLow\u0026nbsp;Ki-67 (\u0026lt;10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e4 (6.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e4 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003eHigh\u0026nbsp;Ki-67 (\u0026ge;10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e55 (93.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e46 (100.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e9 (69.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 209px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKi\u0026nbsp;67 Median\u0026nbsp;(min-max)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e50 (5-92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e60.0 (10-92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e10.0 (5-70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.001\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 633px;\"\u003e\n \u003cp\u003eP-value by Chi-Square test (Fisher\u0026rsquo;s exact probability test). P-value on Ki 67 by Mann-Whitney \u0026nbsp;\u0026nbsp;U\u0026nbsp;test.\u0026nbsp;P-value \u0026lt;0.05\u0026nbsp;is\u0026nbsp;statistically\u0026nbsp;significant.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Distribution of TNM and clinical staging according\u0026nbsp;to Androgen\u0026nbsp;Receptor (AR) expression.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u0026nbsp;cases\u0026nbsp;(n=78)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAndrogen\u0026nbsp;Receptor\u0026nbsp;(AR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative\u0026nbsp;(n=61)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u0026nbsp;(n=17)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT-tumor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eT1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e9 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e8 (13.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eT2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e47 (60.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e33 (54.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e14 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10 (12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eT4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e12 (15.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN-node\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eNX\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e12 (15.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e9 (14.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e3 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eN0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e41 (52.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e30 (48.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e11 (64.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eN1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e12 (15.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10 (16.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eN2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e6 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e5 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eN3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e7 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e7 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM-metastasis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.682\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eM0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e68 (87.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e54 (88.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e14 (82.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eM1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10 (12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e7 (11.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e3 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical\u0026nbsp;staging\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.536\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eStage\u0026nbsp;I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e6 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e5 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eStage\u0026nbsp;II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e42 (53.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e31 (50.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e11 (64.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eStage\u0026nbsp;III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e19 (24.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e17 (27.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eStage\u0026nbsp;IV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e11 (14.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e8 (13.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e3 (17.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecurrence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e58 (74.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e43 (70.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e15 (88.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e20 (25.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e18 (29.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (11.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrgan\u0026nbsp;Involved on\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRecurrence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"8\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.735\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e59 (75.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e44 (72.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e15 (88.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eBrain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eBone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e3 (3.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eLungs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e6 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e6 (9.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eContralateral\u0026nbsp;Breast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (2.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e2 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026ge;2\u0026nbsp;Organs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e6 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e5 (8.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003eLocal recurrence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e1 (1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 612px;\"\u003e\n \u003cp\u003eP-value\u0026nbsp;by\u0026nbsp;Chi-Square\u0026nbsp;test\u0026nbsp;(Fisher\u0026rsquo;s\u0026nbsp;exact\u0026nbsp;probability\u0026nbsp;test).\u0026nbsp;P-value\u0026nbsp;\u0026lt;0.05\u0026nbsp;is\u0026nbsp;statistically\u0026nbsp;significant.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Distribution of swelling size and tumor size according to Androgen\u0026nbsp;Receptor\u0026nbsp;(AR) expression.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u0026nbsp;cases\u0026nbsp;(n=78)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAndrogen\u0026nbsp;Receptor\u0026nbsp;(AR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative\u0026nbsp;(n=61)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u0026nbsp;(n=17)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSwelling\u0026nbsp;size (C/F)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e4.75 (1.0 \u0026ndash; 20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e5.00 (1.0 \u0026ndash; 20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e4.00 (2.0 \u0026ndash; 10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.770\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eMedian\u0026nbsp;(min \u0026ndash; max)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u0026le; 2 cm\u003c/p\u003e\n \u003cp\u003e\u0026gt; 2 - \u0026le; 5 cm\u003c/p\u003e\n \u003cp\u003e\u0026gt; 5 cm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e12 (15.4%)\u003c/p\u003e\n \u003cp\u003e37 (47.4%)\u003c/p\u003e\n \u003cp\u003e29 (37.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e09 (14.8%)\u003c/p\u003e\n \u003cp\u003e30 (49.2%)\u003c/p\u003e\n \u003cp\u003e22 (36.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e03 (17.6%)\u003c/p\u003e\n \u003cp\u003e07 (41.2%)\u003c/p\u003e\n \u003cp\u003e07 (41.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.841\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTumor\u0026nbsp;size\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMedian\u0026nbsp;(min \u0026ndash; max)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e3.75 (0.6 \u0026ndash; 17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e4.00 (1.0 \u0026ndash; 17.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e3.50 (0.6 \u0026ndash; 10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u0026le; 2 cm\u003c/p\u003e\n \u003cp\u003e\u0026gt; 2 - \u0026le; 5 cm\u003c/p\u003e\n \u003cp\u003e\u0026gt; 5 cm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e10 (12.8%)\u003c/p\u003e\n \u003cp\u003e48 (61.5%)\u003c/p\u003e\n \u003cp\u003e20 (25.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e09 (14.8%)\u003c/p\u003e\n \u003cp\u003e33 (54.1%)\u003c/p\u003e\n \u003cp\u003e19 (31.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e01 (5.9%)\u003c/p\u003e\n \u003cp\u003e15 (88.2%)\u003c/p\u003e\n \u003cp\u003e01 (5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.036\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 620px;\"\u003e\n \u003cp\u003eP-values\u0026nbsp;by\u0026nbsp;Mann-Whitney\u0026nbsp;U\u0026nbsp;test.\u0026nbsp;P-value\u0026lt;0.05\u0026nbsp;is\u0026nbsp;statistically\u0026nbsp;significant.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5: Disease-free survival and overall survival according to Androgen\u0026nbsp; \u0026nbsp;Receptor\u0026nbsp;(AR) expression.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"596\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAll\u0026nbsp;cases(n=51)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAndrogen\u0026nbsp;Receptor\u0026nbsp;(AR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNegative(n=40)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePositive\u0026nbsp;(n=11)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisease\u0026nbsp;free\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003esurvival\u0026nbsp;(months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e28.6\u0026nbsp;(24.8-32.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e26.7\u0026nbsp;(22.3-31.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e35.6\u0026nbsp;(29.9-41.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.091\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;(95%\u0026nbsp;CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOverall\u0026nbsp;Survival\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e39.2\u0026nbsp;(29.0-48.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e36.2(26.6-\u0026nbsp;45.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 128px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e37.5\u0026nbsp;(32.3-40.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 140px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;(95%\u0026nbsp;CI)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 596px;\"\u003e\n \u003cp\u003eP-values\u0026nbsp;by\u0026nbsp;Generalized\u0026nbsp;Wilcoxon\u0026nbsp;p\u0026nbsp;test.\u0026nbsp;P-value\u0026nbsp;\u0026lt;\u0026nbsp;0.05\u0026nbsp;is\u0026nbsp;statistically significant.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6: Cox regression analysis of Ki-67 as a predictor of disease-free survival in the study\u0026nbsp;group\u003c/strong\u003e.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKi-67\u0026nbsp;category\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95%CI\u0026nbsp;HR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eLow\u0026nbsp;(\u0026lt;10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.037\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eHigh\u0026nbsp;(\u0026ge;10.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 143px;\"\u003e\n \u003cp\u003e1.12 \u0026ndash; 2.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Androgen receptor, Breast Cancer, Ki67 index, Triple Negative Breast Cancer","lastPublishedDoi":"10.21203/rs.3.rs-6927480/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6927480/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eTriple-negative breast cancers (TNBC) account for 12\u0026ndash;24% of breast cancer cases. They are common in young females with high-grade and poor prognosis. Androgen receptor (AR) is emerging as a new therapeutic target in TNBC.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis retrospective study was undertaken to evaluate the expression of AR by immunohistochemistry in TNBC, to study its relation to potential prognostically significant factors, and to calculate overall survival (OS) \u0026amp; disease-free survival (DFS) in AR-positive and AR-negative cases.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 78 TNBC cases were studied for expression of AR, of which 17 (22%) showed AR positivity and presented at an older age. Around 10 cases showed metastasis at presentation, with lung being the most common organ involved in AR-negative group with statistical significance(p-0.026). Histologic features like infiltrating borders, Ductal carcinoma in-situ (DCIS), and apocrine differentiation were mostly seen in AR-positive tumors, while multifocality, necrosis, LVI, and Modified Bloom Richardson(MBR) grade 3 were seen frequently in AR-negative tumors. The tumor size was larger in AR-negative tumors with a statistically significant value(p-0.036). A statistically significant value(p-0.037) was found with AR expression and low Ki-67 index, indicating higher disease-free survival. Although overall survival and disease-free survival were better in AR-positive than AR-negative, a statistical significance could not be established owing to the small study population.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eAR expression can be a prognostic factor for disease outcome in TNBC patients, and along with Ki-67 might be useful to sub-classify risk in these patients. Thus, AR can be used as a predictive factor for new targeted treatment in TNBC.\u003c/p\u003e","manuscriptTitle":"Exploring the Role of Androgen Receptor Expression in Triple-Negative Breast Cancer: Implications for Targeted Therapy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-09 13:29:44","doi":"10.21203/rs.3.rs-6927480/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-18T12:42:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-01T09:18:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"40934594837449487081488402664192592343","date":"2025-09-25T10:53:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-05T12:06:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"42056271126759071001774343597603887486","date":"2025-09-03T06:36:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-03T06:29:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-03T09:53:10+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-01T18:15:52+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-01T06:46:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Cancer","date":"2025-07-01T06:43:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2446e2a9-b8cc-4da2-ac07-31a5a7a74222","owner":[],"postedDate":"September 9th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-29T05:23:13+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-09 13:29:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6927480","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6927480","identity":"rs-6927480","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}