Tesis

Ekspresi Reseptor Androgen pada Kanker Payudara dan Hubungannya dengan Respons Kemoterapi Neoadjuvan = Androgen Receptor Expression in Breast Cancer and Its Association with Neoadjuvant Chemotherapy Response.

Latar Belakang : Kanker payudara dengan 2,3 juta kasus baru setiap tahunnya merupakan penyebab utama kematian terkait kanker pada wanita di banyak negara. Terjadi eskalasi kemoterapi neoadjuvan pada era Precision Medicine dan penilaian terhadap respons patologis kemoterapi neoadjuvan masih bervariasi sehingga dibutuhkan biomarker prediktif tambahan. Reseptor androgen merupakan biomarker yang sering diekspresikan pada berbagai subtipe kanker payudara dan diduga berhubungan dengan respons kemoterapi neoadjuvan. Tujuan : Menganalisis hubungan ekspresi reseptor androgen pada kanker payudara dengan respons kemoterapi neoadjuvan. Metode : Penelitian kohort retrospektif dilakukan di RSUPN Dr. Cipto Mangunkusumo dan RS Hermina Jatinegara pada Juli-Desember 2025. Sampel diambil secara consecutive dari pasien kanker payudara yang menjalani kemoterapi neoadjuvan dan operasi. Ekspresi reseptor androgen dinilai pada biopsi sebelum kemoterapi neoadjuvan menggunakan imunohistokimia dan Allred score; reseptor androgen positif bila Allred score ≥3. Respons patologis dinilai pada spesimen operasi menggunakan Residual Cancer Burden (RCB) dan dikelompokkan menjadi respons baik (RCB0-RCB1) dan respons buruk (RCB2-RCB3). Analisis dilakukan dengan uji bivariat dan regresi logistik biner untuk mengontrol faktor klinikopatologis utama. Hasil : Dari 57 pasien yang memenuhi kriteria, 52 sampel layak dianalisis. Rerata usia 52,06 ± 10,24 tahun. Proporsi reseptor androgen positif dan negatif masing-masing 50,0%. Respons buruk (RCB2-RCB3) lebih banyak dibanding respons baik (RCB0- RCB1) (57,7% vs 42,3%). Pada analisis bivariat, proporsi respons buruk lebih tinggi pada kelompok reseptor androgen positif dibanding negatif (69,2% vs 46,2%), namun tidak bermakna secara statistik (p=0,092). Pada analisis multivariat, reseptor androgen tidak terbukti sebagai prediktor independen respons buruk (p > 0,05). Kesimpulan : Ekspresi reseptor androgen pada kanker payudara tidak berhubungan secara bermakna dengan respons patologis kemoterapi neoadjuvan berdasarkan RCB pada penelitian ini.
Kata Kunci : kanker payudara; reseptor androgen; kemoterapi neoadjuvan; Residual Cancer Burden; biomarker.


Background: Breast cancer, with 2.3 million new cases annually, is a leading cause of cancer-related death among women in many countries. In the era of precision medicine, the use of neoadjuvant chemotherapy has escalated, while assessment of pathological response remains variable; therefore, additional predictive biomarkers are needed. The androgen receptor is a biomarker frequently expressed across breast cancer subtypes and has been proposed to be associated with neoadjuvant chemotherapy response. Objective: To analyze the association between androgen receptor expression in breast cancer and neoadjuvant chemotherapy response. Methods: A retrospective cohort study was conducted at Dr. Cipto Mangunkusumo National Central General Hospital and Hermina Jatinegara Hospital from July to December 2025. Samples were collected consecutively from breast cancer patients who received neoadjuvant chemotherapy followed by surgery. Androgen receptor expression was assessed on pretreatment biopsy specimens using immunohistochemistry and the Allred scoring system; androgen receptor positivity was defined as an Allred score ≥3. Pathological response was evaluated on surgical specimens using Residual Cancer Burden (RCB) and categorized as good response (RCB0–RCB1) or poor response (RCB2–RCB3). Bivariate analysis and binary logistic regression were performed to adjust for major clinicopathological factors. Results: Of 57 eligible patients, 52 samples were analyzable. The mean age was 52.06 ± 10.24 years. The proportions of androgen receptor–positive and androgen receptor– negative cases were each 50.0%. Poor response (RCB2–RCB3) was more frequent than good response (RCB0–RCB1) (57.7% vs 42.3%). In bivariate analysis, poor response was more common in the androgen receptor–positive group than in the androgen receptor–negative group (69.2% vs 46.2%), but this was not statistically significant (p=0.092). In multivariable analysis, androgen receptor expression was not an independent predictor of poor response (p > 0.05). Conclusion: Androgen receptor expression in breast cancer was not significantly associated with neoadjuvant chemotherapy pathological response assessed by RCB in this study.
Keywords: breast cancer; androgen receptor; neoadjuvant chemotherapy; Residual Cancer Burden; biomarker