Clinicopathological characteristics and survival outcomes of breast Paget disease versus common breast cancer:A propensity score-matched study
ZHENG Cheng-cheng
XU Wei-yu
HUANG Hai-rong
HU Hao
YUAN Zhu
Abstract：Objective To analyze the clinicopathological characteristics and prognosis of breast Paget disease(PDB)compared with common breast cancer(BC).Methods A retrospective study was conducted on 20 PDB patients and 60 BC patients who underwent surgery with histopathological confirmation of invasive ductal carcinoma(IDC)or ductal carcinoma in situ(DCIS)at the Breast Surgery Department of Beijing Friendship Hospital,Capital Medical University,between January 2014 and January 2024.Propensity score matching(PSM)was performed in SPSS 26.0 using 1∶1 nearest-neighbor matching(caliper=0.03)to balance age,menopausal status and common comorbidities.The immunohistochemical profiles(ER,PR,HER-2),molecular subtypes and Ki-67 proliferation index were compared,and overall survival(OS)was assessed via Kaplan-Meier curves with the Log-Rank test.Results Before matching,the mean age at diagnosis was 58.85 years in the PDB group versus 52.48 years in the BC group(P=0.037).Hypertension prevalence was higher in PDB(40.0％vs.15.0％,P=0.040),and TNM stage was earlier(P=0.025).PDB patients are more often presented with nipple discharge or skin changes(P＜0.001).In the PDB group,ER and PR negativity rates were significantly increased,and HER-2 positivity reached 75.0％,with the HER-2-enriched subtype predominant(P＜0.01).Ki-67 index differences were not significant between the two groups.After matching,baseline characteristics were balanced(P＞0.05),but the PDB group still showed higher HER-2 positivity(75.0％vs.31.3％,P=0.013)and HER-2-enriched subtype proportion(68.7％vs.18.7％,P=0.013).Follow-up was conducted until July 01,2024,with a median of 87 months,4 deaths occurred(2 in the PDB group and 2 in the BC group)after matching.The 1-,3-and 5-year OS rates were 100％,88.5％and 83.8％,respectively,with no significant differences between the two groups(P=0.663).Conclusion Breast Paget disease differs significantly from common breast cancer in clinical presentation and pathological features—especially a predominance of the HER-2-enriched immunophenotype—while overall survival is comparable between the two groups.
Keywords：breast Paget diseasebreast cancerpropensity score matchingclinicopathological characteristics
Publication Date：2025-06-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 702-707 )