Adjuvant Surgical Oophorectomy Efficacy According to Hormonally-Determined Menstrual Cycle Phase

Richard R Love

doi:10.34257/gjmrivol21is1pg39

Abstract

Purpose: While there is now considered to be no significant outcome impact of the timing of breast surgery in the menstrual cycle of premenopausal women with breast cancer, the data with respect to adjuvant surgical oophorectomy in women with breast cancer have received limited exposition and attention. In a trial investigating the timing of surgical oophorectomy in women with metastatic disease, we observed a trend for poorer overall survival in women in women in prolonged follicular phases of the menstrual cycle, with low progesterone levels. Methods: The data from a previously reported adjuvant randomized clinical trial addressing the timing of surgical oophorectomy in the menstrual cycle have been examined in detail, presenting here new data from pre-planned secondary analyses. Multivariable Cox models were used.

Highlights

Background betterDFS than those with < 2ng/ml [5].Globally, 500,000 premenopausal women annually present with hormone receptor positive breast cancer
The differences at 5 years compared with luteal phase patients with elevated progesterone levels, were, for disease free survival (DFS) 20% less, multivariable p=0.02; and for overall survival (OS)15 % less, multivariable p=0.036.Other sub-group comparisons in this trial support oophorectomy patients had equivalent overall survival (LH=FH for OS) [6]
The reported new results show that in prepatients with progesterone levels = >5ng/ml—"LH planned exploratory analyses in a second phase confirmed”; and luteal phase-by-history patients with IIIadjuvant study, among the randomized patients, those progesterone levels

Summary

Introduction

DFS than those with < 2ng/ml (aHR 0.53; 95% CI 0.34 – 0.84; p=0.006) [5]. 500,000 premenopausal women annually present with hormone receptor positive breast cancer. For these women with operable disease, This communication reports new data from the adjuvant study, other data, and interpretations relevant to our findings. Surgical oophorectomy or ovarian function-suppression plus tamoxifen are the most effective adjuvant

Methods

Results

Discussion

Conclusion