Timing Of Breast Cancer Surgery Research Articles

The timing of breast cancer surgery with respect to the menstrual cycle. More data which emphasize the need for a prospective study

The timing of breast cancer surgery with respect to the menstrual cycle. More data which emphasize the need for a prospective study

Timing of breast cancer surgery: nodes, hormones, and retrospectoscopy

Timing of breast cancer surgery: nodes, hormones, and retrospectoscopy

Timing of breast cancer surgery — some arguments that there is no effect

Timing of breast cancer surgery — some arguments that there is no effect

Timing of breast cancer surgery during the menstrual cycle

Timing of breast cancer surgery during the menstrual cycle

Menstrual effects on surgical treatment for breast cancer

In 1989, Hrushesky et al. (1) reported preliminary results of a retrospective study which identified the timing of breast cancer surgery in relation to the menstrual cycle as an independent predictor of disease-free survival for 41 premenopausal women. At least a dozen reports have subsequently appeared, some supporting and others refuting the claim. The debate has been played out both in the medical literature and in the lay press, resulting in much confusion for patients and physicians alike. This review will examine the biological plausibility of the hypothesis that the menstrual cycle can influence surgical outcome, the results of clinical studies done to date, and the potential methodological pitfalls inherent in performing these retrospective reviews.

Breast cancer and timing of surgery during menstrual cycle. A 5-year analysis of 385 pre-menopausal women.

It has been proposed that the timing of breast-cancer surgery in relation to menstrual phase has a prognostic impact on outcome. We carefully evaluated a combined 2-center series of 385 pre-menopausal women operated on for stage-I and stage-II breast cancer with a median follow-up of 5 years for a possible impact on outcome of the date of their last menstrual period (LMP) before surgery. The distribution of risk factors of the study cohort as well as prognostic indicators corresponded to previously published results. Nodal status, grading, and (in part) hormone-receptor status differentiate well between patient subgroups with high and low risk of relapse and death after breast-cancer surgery. In neither univariate nor multivariate analysis was any impact of the so-called "unopposed" estrogen secretion detected. We did not observe any effect of LMP on long-term survival in any of several prognostic subgroups, in particular in hormone-receptor-positive patients. From our results and from the literature, we conclude that LMP does not provide any prognostic information for outcome after breast-cancer surgery and therefore the proposed modification of scheduling of breast-cancer operations is not justified.

The timing of breast cancer surgery with menstrual cycle

The timing of breast cancer surgery with menstrual cycle

Timing of breast cancer surgery within the menstrual cycle: Influence on lymph-node involvement, receptor status, postoperative metastatic spread and local recurrence

Prompted by a report of Hrushesky et al. stating that women operated upon for breast cancer during their perimenstrual period showed a higher risk for developing future metastases than women operated upon during their mid-cycle, we examined the patients with breast carcinoma who were treated at the Gynaecological University Hospital Zürich between 1971 and 1988 with respect to the influence of menstrual cycle phase on certain factors. 104 patients underwent perimenstrual surgery, i.e., between days 1 and 6 or days 21 and 36 of the cycle. 120 women had mid-cycle surgery (i.e., days 7-20 of the cycle). In contrast to the experience of Hrushesky et al., we found no significant differences in the survival curves. The same was true when the proliferative phase (days 1-14; n = 109) was compared with the secretory phase (days 15-32; n = 108). We tested the different groups for homogeneity and found that 54% of the patients with perimenstrual surgery showed axillary lymph node involvement, whereas in the midcyclic group only 38% showed positive nodes. We have no plausible explanation for this difference. These findings indicate that there might be certain cycle-related differences with respect to lymph node status but that they do not affect survival. Hence, timing surgery to the menstrual cycle is not mandatory for the time being.

Timing of breast cancer surgery in the menstrual cycle and outcome

Timing of breast cancer surgery in the menstrual cycle and outcome