Prognostic significance of androgen receptor expression in triple-negative breast cancer

Background. Determining androgen receptor (AR) expression in triple-negative breast cancer (TNBC) is a promising tool in oncology.

Aim. To identify the correlation of AR expression with the clinical and genetic characteristics of the tumor and the disease prognosis.

Materials and methods. The study included 246 subjects with TNBC treated at Ulyanovsk Regional Oncological Clinical Dispensary and Kulakov National Medical Research Center for Obstetrics, Gynecology, and Perinatology (Moscow) from 2014 to 2024. The AR expression was determined by immunohistochemical method in all patients. Clinical (age, primary tumor size, number of regional lymph nodes affected, total malignancy score) and genetic (expression level of 44 genes expressed on the ln-scale) tumor parameters were analyzed. Parametric (Student's t-test) and non-parametric (one-way ANOVA) statistical methods were used to evaluate the relationship between AR expression and clinical genetic parameters. An overall survival analysis was performed using Kaplan–Meier curves to determine the prognosis.

Results. A log-rank test was used when comparing survival curves. Differences between groups were considered statistically significant at p<0.05. AR expression is associated with elderly age, metastatic lesions of regional lymph nodes, with the expression of CTSL2, AURKA, KRT5, CCND1, BCL2, FGFR4, TMEM45A, MiKI67, MYBL2, CDKN2A, FOXA1, SFRP1, PTEN, CD68, EMSY, GATA3, EXO1, PPP2R2A, TPX2, PAK1, PTTG1, UBE2T, KIF14, CCNB1, BAG1, TMEM45B, MYC, MIA, BIRC5, PD-L1, TRAC, ZNF703, TYMS, CCNE, ANLN and poor long-term prognosis in TNBC.

Conclusion. TNBC with AR expression is a heterogeneous subtype. It is associated with advanced age, metastatic involvement of regional lymph nodes, and expression of a large number of genes. According to our data, AR expression in TNBC is associated with unfavorable long-term prognosis of this category of patients.