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Characterizing Breast Cancer in a Population with Increased Prevalence of Triple-Negative Breast Cancer: Androgen Receptor and ALDH1 Expression in Ghanaian Women

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The androgen receptor (AR) is a commonly-expressed hormone receptor in breast cancer and may be a marker of response to targeted anti-androgen therapy, a particularly attractive option for triple-negative breast cancer (TNBC). Gene expression studies suggest that ARs may distinguish a luminal/AR TNBC subtype from stem cell-like subtypes. TNBC frequency is two to three times higher in African American and African breast cancers compared with White American and European breast cancers, yet little is known regarding TNBC subtypes in high-frequency African-ancestry populations. We evaluated ARs and the mammary stem cell marker aldehyde dehydrogenase 1 (ALDH1) among breast cancers from Ghana, Africa.

Methods

Overall, 147 formalin-fixed, paraffin-embedded invasive breast cancers from the Komfo Anoyke Teaching Hospital in Ghana were studied at the University of Michigan, and analyzed immunohistochemically for estrogen receptor (ER), progesterone receptor (PR), HER2/neu, ALDH1, and AR expression.

Results

The median age of patients was 45 years. Only 31 cases (21 %) were ER-positive, and 14 (10 %) were HER2-positive; 89 (61 %) were TNBCs. For the entire group, 44 % were AR-positive and 45 % were ALDH1-positive. ER/PR-positive tumors were more likely to be AR-positive compared with ER/PR-negative tumors (87 vs. 26 %; p < 0.0001), but there was no association between ALDH1 and AR expression. Among the TNBC cases, 45 % were ALDH1-positive and 24 % were AR-positive. ALDH1 positivity was associated with AR positivity within the subset of TNBC (36 vs. 14 %; p = 0.019).

Conclusion

We confirmed other studies showing a high frequency of TNBC in Africa. Surprisingly, ALDH1 was found to correlate with AR expression among TNBC, suggesting that novel TNBC subtypes may exist among populations with African ancestry.

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Author notes

    Authors and Affiliations

    1. Department of Surgery, University of Michigan, Ann Arbor, MI, USA

      Erica Proctor MD, Evelyn Jiagge MBChB, Jessica Bensenhaver MD, Kofi Gyan DVM, MPH, MPA, Robert Newman Brewer & Lisa Newman MD, MPH, FACS, FASCO

    2. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA

      Kelley M. Kidwell PhD

    3. Department of Surgery, Komfo Anoyke Teaching Hospital, Kumasi, Ghana

      Evelyn Jiagge MBChB, Joseph Kwaku Oppong MBChB, Ishmael Kyei MBChB & Francis Aitpillah MBChB

    4. Division of Surgical Oncology, University of Michigan Health Systems, Ann Arbor, MI, USA

      Jessica Bensenhaver MD & Lisa Newman MD, MPH, FACS, FASCO

    5. Department of Pathology, University of Michigan, Ann Arbor, MI, USA

      Kathy Toy, Linda Ahenkorah Fondjo PhD, Osei Owusu-Afriyie MBChB & Celina Kleer MD

    6. Department of Oncology, Komfo Anoyke Teaching Hospital, Kumasi, Ghana

      Baffour Awuah MBChB, Ernest Osei-Bonsu MBChB & Michael Ohene-Yeboah MBChB

    7. Department of Pathology, Komfo Anoyke Teaching Hospital, Kumasi, Ghana

      Ernest Adjei MBChB & Osei Owusu-Afriyie MBChB

    8. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

      Evelyn Jiagge MBChB, Max Wicha MD & Sofia Merajver MD, PhD

    9. Breast Care Center, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI, USA

      Jessica Bensenhaver MD, Max Wicha MD, Sofia Merajver MD, PhD, Celina Kleer MD & Lisa Newman MD, MPH, FACS, FASCO

    Authors
    1. Erica Proctor MD
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    2. Kelley M. Kidwell PhD
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    3. Evelyn Jiagge MBChB
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    4. Jessica Bensenhaver MD
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    5. Baffour Awuah MBChB
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    6. Kofi Gyan DVM, MPH, MPA
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    7. Kathy Toy
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    8. Joseph Kwaku Oppong MBChB
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    9. Ishmael Kyei MBChB
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    10. Francis Aitpillah MBChB
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    11. Ernest Osei-Bonsu MBChB
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    12. Ernest Adjei MBChB
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    13. Michael Ohene-Yeboah MBChB
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    14. Robert Newman Brewer
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    15. Linda Ahenkorah Fondjo PhD
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    16. Osei Owusu-Afriyie MBChB
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    17. Max Wicha MD
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    18. Sofia Merajver MD, PhD
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    19. Celina Kleer MD
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    20. Lisa Newman MD, MPH, FACS, FASCO
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    Corresponding author

    Correspondence to Lisa Newman MD, MPH, FACS, FASCO.

    Additional information

    As senior authors, Celina Kleer and Lisa Newman have contributed equally to this research and associated manuscript.

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    Proctor, E., Kidwell, K.M., Jiagge, E. et al. Characterizing Breast Cancer in a Population with Increased Prevalence of Triple-Negative Breast Cancer: Androgen Receptor and ALDH1 Expression in Ghanaian Women. Ann Surg Oncol 22, 3831–3835 (2015). https://doi.org/10.1245/s10434-015-4455-x

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    • DOI: https://doi.org/10.1245/s10434-015-4455-x

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