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Impact of androgen receptor on triple negative breast cancer: a systematic review and meta-analytic study

bmjph · 2026-01-27 · canonical JSON source

9 visible annotations · policy: published · automated confidence ≥ 75.00%

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Objectives To evaluate the prognostic impact of androgen receptor (AR) protein expression on disease-free survival (DFS) and overall survival (OS) in patients with triple-negative breast cancer (TNBC).Design Systematic review and meta-analysis.Data sources Cochrane Library, MEDLINE, Embase, Google Scholar and Web of Science (1 January 2000–30 November 2024).Eligibility criteria Studies assessing AR protein expression in tumour tissue from female TNBC patients using immunohistochemistry and reporting multivariable HRs with 95% CIs for DFS and/or OS were eligible.Data extraction and synthesis Screening, data extraction and risk-of-bias assessment were performed independently and in duplicate. Random-effects meta-analyses were conducted using the DerSimonian-Laird method with Hartung-Knapp-Sidik-Jonkman adjustment. Subgroup, meta-regression and leave-one-out sensitivity analyses explored heterogeneity. Publication bias was assessed with funnel plots and Egger’s test. Study quality was appraised using the Cochrane Risk of Bias 2 tool.Results 11 studies involving 4446 patients were included; AR was expressed in 1261 (28.4%). AR positivity showed a non-significant trend towards improved DFS (HR 0.67, 95% CI 0.44 to 1.03; p=0.07) and OS (HR 0.76, 95% CI 0.49 to 1.18; p=0.20). Subgroup analyses demonstrated significant DFS benefits in studies with ≤5 years’ follow-up (HR 0.81, 95% CI 0.60 to 1.10; p=0.03) and in upper-middle-income countries (HR 0.45, 95% CI 0.24 to 0.83; p=0.01). Meta-regression identified AR cut-off (≥5%) as a significant moderator (HR 0.33, 95% CI 0.27 to 0.41; p<0.0001), explaining 31.6% of between-study heterogeneity. No significant publication bias was detected.Conclusion In TNBC, AR expression appears to confer short-term DFS benefit but not improved OS or longer-term outcomes. Although significance was observed only in certain subgroups, AR status may have clinical value and warrants further investigation using standardised assessment methods.PROSPERO registration number CRD42023447385.