Previous in vitro studies demonstrated that bioactive androgen 5a-dihydrotestosterone (DHT) exerted antiproliferative effects through an interaction with androgen receptor (AR) in breast carcinoma cells. However, AR status has not been examined in association with DHT concentration in breast carcinoma tissues, and significance of androgenic actions remains unclear in breast carcinomas. Therefore, in our study, we first examined intratumoral DHT concentrations in 38 breast carcinoma tissues using liquid chromatography/electrospray tandem mass spectrometry. Intratumoral DHT concentration was positively associated with 5a-reductase type 1 (5aRed1), and negatively correlated with aromatase. We then examined clinical significance of AR and 5aRed1 status in 115 breast carcinoma tissues by immunohistochemistry. Breast carcinomas positive for both AR and 5aRed1 were inversely associated with tumor size or Ki-67. These patients showed significant associations with a decreased risk of recurrence and improved prognosis for overall survival, and the AR / 5aRed1 status was demonstrated an independent prognostic factor. Moreover, we examined possible regulation of DHT production by aromatase in in vitro studies. DHT synthesis from androstenedione in MCF-7 cells was significantly inhibited by coculture with aromatase-positive stromal cells, which was significantly reversed by addition of aromatase inhibitor exemestane. These results suggest that intratumoral DHT concentration is mainly determined by 5aRed1 and aromatase in breast carcinoma tissues, and antiproliferative effect of DHT may primarily occur in the cases positive for both AR and 5aRed1. Aromatase inhibitors may be more effective in these patients, possibly due to increasing local DHT concentration with estrogen deprivation. ' 2006 Wiley-Liss, Inc.Key words: breast cancer; androgen; androgen receptor; 5a-reductase; aromatase It is well-known that sex-steroids play important roles in the development of hormone-dependent human breast carcinomas. Among these sex-steroids, estrogens immensely contribute to growth of breast carcinoma through binding with estrogen receptor (ER). 1 In contrast, androgens are considered to predominantly exert antiproliferative effects via androgen receptor (AR) in breast carcinoma cells, 2-5 although some divergent findings have been reported. 6 AR is expressed in a majority of human breast carcinoma tissues, 7-11 suggesting important roles of androgens in breast carcinomas.5a-dihydrotestosterone (DHT) binds with the highest affinity to AR, and together with testosterone promotes AR transcriptional activity. 12 Androgen concentrations have been previously examined in breast cancers by 2 groups, 13,14 and the potent androgen DHT was demonstrated to be significantly higher in breast carcinoma tissues than in plasma in these studies. Androgen-producing enzymes, such as17b-hydroxysteroid dehydrogenase type 5 (17bHSD5, conversion from circulating androstenedione to testosterone) and 5a-reductase (5aRed, reduction of testosterone to DHT), were ex...