The Prognostic Values of Androgen Receptor in Breast Cancer

Abstract

Context.— Whether androgen receptor (AR) expression can predict prognosis in breast cancer is under debate. Objective.— To analyze, retrospectively, the prognostic and treatment predictive ability of AR status in breast cancer. Design.— A total of 5765 patients diagnosed with primary invasive breast cancer without distant metastasis in the adjuvant setting were analyzed. The propensity score matching method was used to develop a new cohort of 3978 patients (1989 patients each) in which important prognostic factors were balanced. Results.— Positive AR expression is an independent prognostic factor for disease-free survival and overall survival. Estrogen receptor (ER)+ and progesterone receptor (PR)+ AR+ breast cancer patients were associated with the longest survival, whereas ER−PR−AR− breast cancer patients were associated with the shortest survival. The ER/PR/AR combinations could not predict the treatment effects for adjuvant trastuzumab but could be used for adjuvant chemotherapy and endocrine therapy selection. The worst survival was found in ER+PR−AR− patients receiving toremifene, ER+PR−AR+ patients receiving exemestane, ER+PR+AR− patients receiving anthracycline, and ER−PR−AR+ patients receiving taxanes. ER+PR−AR−, ER−PR−AR+, and ER−PR−AR− patients were associated with the worst survival among those who received radiotherapy and anthracycline plus taxanes. Conclusions.— AR in combination with ER and PR could predict the prognosis and treatment effects of chemotherapy, endocrine therapy, and radiotherapy in the adjuvant setting.