{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T22:05:56Z","timestamp":1784153156100,"version":"3.55.0"},"reference-count":0,"publisher":"Association of Basic Medical Sciences of FBIH","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomol Biomed"],"abstract":"<jats:p>Mastectomy has traditionally been the dominant surgical approach for mammary Paget disease, but its survival advantage over breast-conserving surgery (BCS) remains uncertain. We compared breast cancer-specific survival (BCSS) and overall survival (OS) after mastectomy versus BCS in a population-based SEER cohort. Female patients with mammary Paget disease diagnosed between 2000 and 2022 were identified; after exclusions, 641 surgically treated patients were included, of whom 323 underwent BCS and 318 underwent mastectomy. The primary treatment-strategy effect was estimated using inverse-probability-of-treatment weighting, with radiotherapy excluded from the propensity model as a mediator on the BCS pathway. A 1:1 propensity-matched cohort served as a sensitivity analysis. Survival was assessed using Kaplan\u2013Meier analysis, multivariable Cox regression, Aalen\u2013Johansen competing-risk estimation, Fine\u2013Gray modelling, and additional robustness analyses.\u00a0After matching, 228 pairs were analyzed. Five-year BCSS was 95.8% after BCS and 94.1% after mastectomy; corresponding ten-year estimates were 93.4% and 92.2% (log-rank p = 0.72). Ten-year cumulative incidence of breast cancer-specific death was 6.3% versus 7.4%, respectively, after accounting for competing non-cancer mortality. OS did not differ significantly between groups (p = 0.46). Mastectomy was not associated with improved BCSS in the primary weighted analysis (hazard ratio 1.19, 95% confidence interval 0.66\u20132.14, p = 0.56) or the matched sensitivity analysis (hazard ratio 1.30, 95% confidence interval 0.58\u20132.88, p = 0.52). Findings were concordant across competing-risk, overlap-weighted, parsimonious, penalized, and age-stratified models.\u00a0In this SEER-based, propensity-adjusted analysis, mastectomy was not associated with a detectable survival advantage over BCS in women with mammary Paget disease. These findings support BCS as a reasonable option in selected patients, while prospective studies incorporating margin status, receptor biology, local recurrence, and patient-reported outcomes are needed.<\/jats:p>","DOI":"10.17305\/bb.2026.14512","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:19:48Z","timestamp":1782890388000},"source":"Crossref","is-referenced-by-count":0,"title":["Survival after breast-conserving surgery versus mastectomy in mammary Paget disease: A propensity-matched SEER population-based analysis"],"prefix":"10.17305","author":[{"given":"\u0130smail","family":"Z\u0130hn\u0130","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Zafer","family":"Sabuncuo\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6922","published-online":{"date-parts":[[2026,7,1]]},"container-title":["Biomolecules and Biomedicine"],"original-title":[],"link":[{"URL":"https:\/\/bjbms.org\/ojs\/index.php\/bjbms\/article\/download\/14512\/4239","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjbms.org\/ojs\/index.php\/bjbms\/article\/download\/14512\/4239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T22:00:52Z","timestamp":1784152852000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjbms.org\/ojs\/index.php\/bjbms\/article\/view\/14512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":0,"URL":"https:\/\/doi.org\/10.17305\/bb.2026.14512","relation":{},"ISSN":["2831-090X","2831-0896"],"issn-type":[{"value":"2831-090X","type":"electronic"},{"value":"2831-0896","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}