The Prognostic Values of Androgen Receptor in Breast Cancer A Hospital-Based Retrospective and Propensity Score-Matched Cohort

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 recep-tor (PR)+ AR+ breast cancer patients had the longest survival, whereas ER -PR -AR- breast cancer patients had 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 receiv-ing 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.