J Breast Cancer.  2015 Jun;18(2):134-142. 10.4048/jbc.2015.18.2.134.

Influence of Androgen Receptor Expression on the Survival Outcomes in Breast Cancer: A Meta-Analysis

• Kim Y
• Jae E
• Yoon M

• KMID: 2374528
• DOI: http://doi.org/10.4048/jbc.2015.18.2.134

Abstract

PURPOSE
Despite the fact that the androgen receptor (AR) is known to be involved in the pathogenesis of breast cancer, its prognostic effect remains controversial. In this meta-analysis, we explored AR expression and its impact on survival outcomes in breast cancer.
METHODS
We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, and Ovid databases and references of articles to identify studies reporting data until December 2013. Disease-free survival (DFS) and overall survival (OS) were analyzed by extracting the number of patients with recurrence and survival according to AR expression.
RESULTS
There were 16 articles that met the criteria for inclusion in our meta-analysis. DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively). In addition, hormone receptor (HR) positive patients had a longer DFS when AR was also expressed (OR, 0.63; 95% CI, 0.41-0.98). For patients with triple negative breast cancer (TNBC), AR expression was also associated with longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75; OR, 0.26, 95% CI, 0.12-0.55, respectively). Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively). However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73).
CONCLUSION
Expression of AR in breast cancer might be associated with better survival outcomes, especially in patients with HR-positive tumors and TNBC, and women. Based on this meta-analysis, we propose that AR expression might be related to prognostic features and contribute to clinical outcomes.

Keyword

Androgen receptors; Breast neoplasms; Disease-free survival; Mortality

MeSH Terms

Breast Neoplasms*
Disease-Free Survival
Female
Humans
Male
Mortality
Receptors, Androgen*
Recurrence
Triple Negative Breast Neoplasms
Receptors, Androgen

Figure

• 

  Figure 1 Flow diagram of included studies. AR=androgen receptor.

• 

  Figure 2 Funnel plots of (A) disease-free survival and (B) overall survival of the included studies. The funnel plots showed symmetricity which proposed no publication bias. SE=standard error; OR=odds ratio.

• 

  Figure 3 Forest plots of (A) disease-free survival (DFS) and (B) overall survival (OS) of the included studies. In androgen receptor (AR) expressed tumors, DFS and OS showed statistically significant improvement compared with no AR expression. M-H=Mantel-Haenszel; CI=confidence interval. *5-Year survival data.

• 

  Figure 4 Forest plots of survival outcomes according to hormonal receptor status. (A) Disease-free survival and (B) overall survival in patients with hormonal receptor expression. (C) Disease-free survival and (D) overall survival in patients without hormonal receptor expression. M-H=Mantel-Haenszel; CI=confidence interval; AR= androgen receptor. *5-Year survival data.

• 

  Figure 5 Forest plots of survival outcomes according to molecular subtypes. (A) Disease-free survival and (B) overall survival in patients with triple-negative breast cancer (TNBC). (C) Disease-free survival and (D) overall survival in patients with non-TNBC. M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor.

• 

  Figure 6 Forest plots of survival outcomes by gender. (A) Disease-free survival and (B) overall survival in men. (C) Disease-free survival and (D) overall survival in women. M-H=Mantel-Haenszel; CI=confidence interval; AR=androgen receptor. *5-Year survival data.

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