Badwe R A, Gregory W M, Chaudary M A, Richards M A, Bentley A E, Rubens R D, Fentiman I S
ICRF Clinical Oncology Unit, Guy's Hospital, London, UK.
Lancet. 1991 May 25;337(8752):1261-4. doi: 10.1016/0140-6736(91)92927-t.
Timing of operation in relation to menstrual phase might affect outlook in premenopausal women with operable breast cancer. We examined the records of 249 such women treated between 1975 and 1985, and compared overall and recurrence-free survival in those whose operation was 3-12 days after their last menstrual period (LMP) (group 1, n = 75) with those in whom it was 0-2 or 13-32 days after LMP (group 2, n = 174). Overall and recurrence-free survival were greatly reduced in group 1 women (p less than 0.001 for both). Actuarial survival at 10 years was 54% in group 1 versus 84% in group 2. This effect was independent of other factors, was of much the same importance as nodal status in multivariate analysis, was largely confined to histologically node-positive cases, seemed to be greater in women with small tumours (less than or equal to 2 cm), and was seen in patients with oestrogen-receptor positive and negative tumours. Thus phase of menstrual cycle at operation is of great importance for long-term outlook in premenopausal women with breast cancer.
手术时间与月经周期的关系可能会影响可手术乳腺癌的绝经前女性的预后。我们查阅了1975年至1985年间接受治疗的249名此类女性的记录，并比较了末次月经（LMP）后3 - 12天接受手术的患者（第1组，n = 75）与LMP后0 - 2天或13 - 32天接受手术的患者（第2组，n = 174）的总生存率和无复发生存率。第1组女性的总生存率和无复发生存率大幅降低（两者p均小于0.001）。第1组10年精算生存率为54%，而第2组为84%。这种影响独立于其他因素，在多变量分析中与淋巴结状态的重要性相当，主要局限于组织学检查淋巴结阳性的病例，在肿瘤较小（小于或等于2 cm）的女性中似乎更大，并且在雌激素受体阳性和阴性肿瘤患者中均可见。因此，手术时的月经周期阶段对绝经前乳腺癌女性的长期预后非常重要。
