{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:00:24Z","timestamp":1790352024878,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Breast\u2010conserving therapy (BCT), defined as breast\u2010conserving surgery followed by radiotherapy, and mastectomy without radiotherapy, are widely used local treatment strategies for breast cancer; however, survival comparisons between these approaches may be confounded by intrinsic tumor biology. The PAM50 gene expression classifier defines biologically distinct molecular subtypes with established prognostic relevance. We evaluated survival outcomes between these surgical approaches in estrogen receptor\u2013positive breast cancer while accounting for intrinsic molecular subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC), we conducted a retrospective cohort study of estrogen receptor\u2013positive patients treated with either BCT or mastectomy without radiotherapy. Inverse probability of treatment weighting balanced clinicopathologic and treatment\u2010related variables. PAM50 subtype was excluded from the propensity\u2010score model but retained in the weighted survival models because of its prognostic relevance. Weighted Cox proportional hazards models evaluated breast cancer\u2013specific survival (BCSS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mastectomy without radiotherapy was associated with worse BCSS (HR 1.59, 95% CI 1.19\u20132.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and worse OS (HR 1.55, 95% CI 1.26\u20131.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared with BCT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BCT was associated with improved breast cancer\u2013specific and overall survival after adjustment for clinicopathologic and molecular factors.<\/jats:p>\n      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