Prognostic Effect Of Timing Of Surgery In Relation To Menstrual Phase Of Breast Cancer Patient

Objective: Several studies have suggested that the timing of surgery in relation to the menstrual cycle might influence survive of premenopausal women with breast carcinoma. In order to investigate if patients operated during luteal phase have a better prognosis and what may be accounted for timing of surgery, we retrospectively analyzed 164 premenopausal breast cancer cases operated between 1992 and 1996. Methods: All patients were classified as follicular phase group and luteal phase group, according to menstrual history and operation date. Expressions of EGFR, VEGF, TGF-β1, Bcl-2, ER, PR protein in paraffin-embedded breast carcinoma tissue were detected by labeled streptavidin biotin immunohistochemical technique. The risk factors of the premenopausal women with breast carcinoma suffered to relapse and/or metastasis after radical excision were analyzed. Results: In univariate analysis, disease-free survival rate of the follicular phase group was significantly unfavourable, compared with luteal phase group (P<0.01). The logistic regression analysis indicated that axillary lymph node metastasis, age, tumor size, timing of surgery and pathologic type were the risk factors of relapse and/or mestatisis. The odds ratio of the follicular phase group was 2.812 (P<0.05). The positive rate of VEGF and EGFR was significantly higher in patients undergoing surgery during the follicular phase of menstrual cycle. Conclusion: It implies that proteins of EGFR and VEGF may be accounted for unfavourable prognosis of patients operated during the follicular phase of the menstrual cycle. The timing of surgery could be considered as one of methods to increase the survival rate of premenopausal women with breast carcinoma, but prospective studies are also required.