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Hum Pathol. 2018 Oct;80:239-245. doi: 10.1016/j.humpath.2018.06.003. Epub 2018 Jun 11.

Androgen receptor expression is a favorable prognostic factor in triple-negative breast cancers.

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Department of Pathology, Yale University School of Medicine, New Haven, CT, USA. Electronic address:
Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Department of Pathology, Gulhane School of Medicine and Training Hospital, Etlik, Ankara, Turkey.


Androgen receptor (AR) expression is an emerging prognostic marker that has been observed in 25% to 75% of triple-negative breast cancers (TNBCs) that lack estrogen receptor, progesterone receptor and HER2 overexpression. TNBCs are treated with AR-targeted therapies and standardized evaluation of AR expression may help guide patient management. Basal-like TNBCs are a subgroup of TNBCs defined by positive immunoreactivity for CK5/6 or EGFR that carry a worse prognosis. However, it's unclear whether basal-like TNBCs have a different rate of AR positivity or if AR expression is predictive of disease-free survival (DFS) in this patient group. Here, we examined a total of 185 TNBCs for AR and CK5/6 using tissue microarrays (TMAs). Among all samples, 32% were AR positive using a 1% cutoff, and 24% were AR positive using a 10% cutoff. Ninety (49%) TNBCs were CK5/6 positive with lower intensity of AR expression compared to CK5/6-negative cases. There was no significant difference in pathologic stage, tumor size, histologic grade and type, or lymph node stage after stratifying by AR and CK5/6 positivity. AR-positive TNBCs had better overall survival (OS) and DFS compared to AR-negative TNBCs. In addition, increased AR expression carried a dose-dependent effect on DFS. AR expression, nodal status and tumor size were significant predictors of disease-free and overall survival in a multivariable model adjusted for CK5/6 expression, age, histologic grade, and mitotic rate. In conclusion, our data demonstrated that AR positivity is a favorable prognostic factor for triple-negative breast cancers.


Androgen receptor; Basal-like breast cancers; Biomarkers; Cytokeratin 5/6 (CK5/6); Triple-negative breast cancers

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