Corder A P, Cross M, Julious S A, Mullee M A, Taylor I
University Surgical Unit, Southampton General Hospital, UK.
Postgrad Med J. 1994 Apr;70(822):281-4. doi: 10.1136/pgmj.70.822.281.
The effects of the timing of surgery, fine needle aspiration cytology (FNAC) and mammography within the menstrual cycle were investigated retrospectively in 211 premenopausal breast cancer patients. The day of surgery within the menstrual cycle was known for 157 women whose menstrual cycles were regular. Recurrence and survival were closely similar whether surgery was performed during days 3-12 or at other times (days 0-2 or 13-32) in the cycle. Outcome was also unrelated to the timing of mammography which was known in 101 cases. There were no significant differences in recurrence or survival associated with the timing of FNAC when all patients were considered. In the subset of lymph node negative patients (n = 32), however, FNAC outside days 3-12 was associated with a significantly decreased rate of relapse (RR = 0.25, 95% CI = 0.07-0.9) and death (RR = 0.10, 95% CI = 0.02-0.9). These patients, however, also had significantly smaller tumours (median = 2 cm, interquartile range = 2-3 cm) than patients having FNAC on days 3-12 of the cycle (median = 3, interquartile range = 2-4) (Mann-Whitney: z = 2.11, P = 0.04). We have not confirmed that surgery or FNAC during days 3-12 of the cycle is associated with a poorer outcome than interventions during other parts of the cycle.
我们对211例绝经前乳腺癌患者进行了回顾性研究，以调查手术时机、细针穿刺细胞学检查（FNAC）及乳房X线摄影在月经周期内的影响。157名月经周期规律的女性患者的手术日期处于月经周期的哪一天是已知的。无论手术是在月经周期的第3 - 12天进行，还是在其他时间（第0 - 2天或第13 - 32天）进行，复发率和生存率都非常相似。在101例已知乳房X线摄影时间的病例中，结果也与乳房X线摄影的时间无关。当考虑所有患者时，FNAC的时间与复发或生存没有显著差异。然而，在淋巴结阴性患者亚组（n = 32）中，在第3 - 12天之外进行FNAC与复发率（RR = 0.25，95%CI = 0.07 - 0.9）和死亡率（RR = 0.10，95%CI = 0.02 - 0.9）显著降低相关。然而，这些患者的肿瘤也明显小于在月经周期第3 - 12天进行FNAC的患者（中位数 = 2 cm，四分位间距 = 2 - 3 cm）（Mann - Whitney检验：z = 2.11，P = 0.04）（中位数 = 3，四分位间距 = 2 - 4）。我们尚未证实月经周期第3 - 12天进行手术或FNAC与在月经周期其他时间进行干预相比会导致更差的结果。
