Zhu C, et al. - Researchers, via this research, sought to examine how sperm-associated antigen 5 (SPAG5) gene expression is associated with clinicopathological factors and survival outcomes in breast cancer patients. A breast cancer database yielded data of 5,667 patients with a mean follow-up of 69 months. The analysis revealed significantly higher mean SPAG5 expression value in correlation with some clinicopathological factors that resulted in tumor promotion and progression, including poor differentiated type, HER2 positive or TP53 mutated breast cancer. The ROC-analysis suggests SPAG5 as a suitable prognostic marker of poor survival. SPAG5 had only a moderate and not significant predictive impact on survival outcomes in patients who received chemotherapy alone. However, findings support the possible independent prognostic and predictive value of SPAG5 with clinical utility, particularly in ER+ breast cancer patients who received hormonal therapy.