{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:50:26Z","timestamp":1769046626942,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2015,9,16]],"date-time":"2015-09-16T00:00:00Z","timestamp":1442361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2015,12,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The objective of this study was to examine the effect of Paget disease (PD) on axillary lymph node metastases and survival in patients who had concomitant invasive ductal carcinoma (PD\u2010IDC).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The Surveillance, Epidemiology, and End Results (SEER) database was used to identify women who were diagnosed with PD\u2010IDC from 2000 to 2011, comparing baseline demographic and tumor characteristics with those who were diagnosed with IDC alone during the same period. Multivariable logistic regression was used to examine the association of PD\u2010IDC with axillary lymph node metastasis, and breast cancer\u2010specific survival and overall survival were compared between the PD\u2010IDC and IDC groups using the Kaplan\u2010Meier method and Cox proportional hazards regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The study cohort included 1102 patients with PD\u2010IDC and 302,242 controls with IDC alone. PD\u2010IDC tumors were more likely to be centrally located (26.9% vs 5.5%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), high grade (63.5% vs 40.3%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), &gt;2 cm in greatest dimension (47.1% vs 35.7%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and estrogen\/progesterone receptor\u2010negative (45.2% vs 22.1%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). In adjusted analyses, patients with PD\u2010IDC had higher odds of axillary lymph node metastasis (odds ratio, 1.83; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The unadjusted 10\u2010year breast cancer\u2010specific and overall survival rates were lower for the PD\u2010IDC group compared with the IDC\u2010alone group, although, after adjusting for disease stage, tumor characteristics, and local therapy, no significant differences in mortality risk were observed between the 2 groups (hazard ratio, 0.91; <jats:italic>P<\/jats:italic>\u2009=\u2009.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>PD\u2010IDC is associated with an increased risk of axillary lymph node metastasis, but not with inferior survival, compared with IDC alone after adjustment for other disease factors. <jats:bold><jats:italic>Cancer<\/jats:italic> 2015;121:4333\u201340.<\/jats:bold> \u00a9 <jats:italic>2015 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.29687","type":"journal-article","created":{"date-parts":[[2015,9,16]],"date-time":"2015-09-16T11:35:11Z","timestamp":1442403311000},"page":"4333-4340","source":"Crossref","is-referenced-by-count":25,"title":["The effect of Paget disease on axillary lymph node metastases and survival in invasive ductal carcinoma"],"prefix":"10.1002","volume":"121","author":[{"given":"Stephanie M.","family":"Wong","sequence":"first","affiliation":[{"name":"Harvard School of Public Health Boston Massachusetts"},{"name":"Department of Surgery McGill University Health Center Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel A.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuaki","family":"Sagara","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital\/Dana\u2010Farber Cancer Institute Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily F.","family":"Stamell","sequence":"additional","affiliation":[{"name":"Harvard School of Public Health Boston Massachusetts"},{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D.","family":"Desantis","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Dana\u2010Farber Cancer Institute Boston Massachusetts"},{"name":"Department of Surgery Brigham and Women's Hospital\/Dana\u2010Farber Cancer Institute Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William T.","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology Dana\u2010Farber Cancer Institute Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehra","family":"Golshan","sequence":"additional","affiliation":[{"name":"Department of Surgery Brigham and Women's Hospital\/Dana\u2010Farber Cancer Institute Boston 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