Background:: Androgen receptor (AR) upstreams complex signaling pathways that regulate cell proliferation and contribute to breast tumorignensis. Several clinical trials were initiated to investigate the clinical relevance of targeting AR especially in hormone-receptor-negative breast cancer. Methods:: The search was performed in PubMed and the meeting libraries of ASCO, ESMO, SABCS, ImpakT congresses from January 2005 to July 2017. The following key words were used: Breast cancer, Androgen receptor, androgen agonist/antagonist, Flutamide, Abiraterone, Bicalutamide, Enzalutamide, Enobosarm, selective androgen receptor modulator. Results:: Screening of title/abstracts yielded a total of 20 relevant results. Of those, twelve studies were found eligible: eleven clinical trials along with one case report. Response rates ranged from 0 to 12% while clinical benefit rates reached up to 35% in 2 studies (with enzalutamide and enobosarm). Progression-free survival ranged from 2.8 to 4.5 months. The most widely used cutoff for AR expression was 10%. High expression of AR was associated with more clinical benefit. Regarding safety, anti-androgens were generally well tolerated with hot flushes, elevated transaminases and fatigue being the most commonly reported across all agents. Conclusion:: Androgen receptor pathway targeting in advanced breast cancer remains a valid option with reasonable clinical benefit in non-selected patients. Future studies are needed to define an AR addicted cohort with better responses and outcome.

Background: Pregnancy-associated breast cancer (PABC) is one of the common malignancies during pregnancy. Limited data is present about the effect of anticancer therapy on children born to mothers exposed to in utero treatments. Aim: To describe the outcome of pregnancy in a cohort of Egyptian patients treated for PABC. Methods: We reviewed all breast cancer cases diagnosed during pregnancy at two large Egyptian institutions between January 2009 and December 2016. Thirty-eight patients with complete obstetric and fetal data were included. Results: All patients received anthracycline-based chemotherapy in the 2 nd and 3 rd trimesters and 9 of them received paclitaxel. The mean gestational age at delivery was 35.7 ± 3.4 weeks. The mean birth weight was 2736 ± 768 grams. Congenital anomaly (cleft lip and tongue tie) was reported in only one (4%) child. Perinatal death occurred in one (4%) baby due to prematurity. One (4%) child was exposed to trastuzumab in utero in the 1 st trimester and he was completely healthy. Two (8%) other children were exposed to tamoxifen with no complications either neonatal or postnatal. Conclusion: Chemotherapy during pregnancy may be used with minimal maternal and fetal complications. Multidisciplinary approach is crucial for better management. Continued long-term follow-up of the children in this cohort is required.

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