Androgen Receptor Expression and Prognosis in Estrogen Receptor–Positive, HER2-Negative Invasive Ductal Breast Cancer: A Retrospective Longitudinal Cohort from a Specialized Breast Cancer Center (2010–2024)
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Abstract
Objective: To determine androgen receptor (AR) expression and evaluate its association with disease-free survival (DFS), overall survival (OS), and clinicopathologic characteristics in patients with estrogen receptor–positive (ER+), HER2-negative invasive ductal breast cancer.
Methods: Retrospective, longitudinal, observational study conducted at a specialized breast disease institute. From a database of 293 ER+ / HER2-negative patients diagnosed between 2010–2014 and followed through October 31, 2024, 87 eligible patients with available tumor tissue were included (clinical stage IIA–IIIC). AR expression was assessed by immunohistochemistry and categorized as positive when nuclear staining exceeded 10% of tumor cells. Clinicopathologic variables and treatments were compared by AR status. DFS and OS were estimated using Kaplan–Meier curves and compared using log-rank tests. Prognostic factors were explored using univariate Cox proportional hazards models.
Results: AR was positive in 78/87 patients (89.7%) and negative in 9/87 (10.3%). No significant differences were observed between AR-positive and AR-negative groups regarding age, menopausal status, clinical stage, pathologic stage, tumor size, nodal status, grade, lymphovascular invasion, luminal subtype, or treatment patterns. AR expression was not associated with DFS (log-rank p = 0.698) or OS (log-rank p = 0.868). In univariate Cox analysis for DFS, age group (HR 0.574; p = 0.023), ovarian function status (HR 2.977; p = 0.038), and clinical tumor size (HR 3.130; p = 0.024) were prognostic; no variables were prognostic for OS.
Conclusions: In this ER+ / HER2-negative cohort, AR expression was highly prevalent but was not significantly associated with DFS or OS. Recurrence risk appeared more strongly influenced by age, ovarian function status, and tumor size than by AR expression.
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