Rageth J C, Wyss P, Unger C, Hochuli E
Department of Gynaecology and Obstetrics, University Hospital, Zürich, Switzerland.
Ann Oncol. 1991 Apr;2(4):269-72. doi: 10.1093/oxfordjournals.annonc.a057935.
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.
受赫鲁谢斯基等人报告的启发，该报告指出，在围经期接受乳腺癌手术的女性比在月经周期中期接受手术的女性发生未来转移的风险更高，我们研究了1971年至1988年期间在苏黎世大学妇科医院接受治疗的乳腺癌患者月经周期阶段对某些因素的影响。104例患者接受了围经期手术，即在月经周期的第1至6天或第21至36天。120名女性接受了月经周期中期手术（即月经周期的第7至20天）。与赫鲁谢斯基等人的经验相反，我们发现生存曲线没有显著差异。将增殖期（第1至14天；n = 109）与分泌期（第15至32天；n = 108）进行比较时也是如此。我们对不同组进行了同质性测试，发现54%接受围经期手术的患者有腋窝淋巴结受累，而在月经周期中期组中只有38%的患者淋巴结呈阳性。我们对此差异没有合理的解释。这些发现表明，在淋巴结状态方面可能存在某些与周期相关的差异，但它们不影响生存。因此，目前没有必要根据月经周期安排手术时间。
