بررسي رابطه زمان عمل جراحي در فازهاي مختلف سيكل قاعدگي با پيش آگهي بيماران مبتلا به سرطان پستان

Background: Controversies about the improvement of survival in premenopausal breast cancer womenʹs which begun in 1989 with Hrushesky study still continue. With respect to the importance of prognosis in breast cancer and to determine the relation between timing of surgery in menstrual cycle and prognosis, this study was conducted on premenopausal breast cancer womenʹs treated in Jorjani hospital during a 5-yaer period, 1993-98. Materials and methods: In this historical cohort study, 58 premenopausal women with operable breast cancer and regular menses were analyzed in two groups according to the time of surgery, follicular and luteal phase of menstrual cycle. All patients had lymph node involvement and all of them received exactly the same systemic and local adjuvant therapy. Overall and disease free survival (OS, DFS) curves were calculated according to the Kaplan Meier method and the differences between the curves were compared by Log rank p test. Results: Patients were followed at least for 17 months, where the mean follow up was 58.3 months. There was no statistically significant differences in DFS and OS between two groups (log rank p value=0.41 and 0.57, respectively). The impact of time of the surgery and phase of menstrual cycle was not confirmed by univariate and multivariate analysis. Conclusion: Our finding does not support the hypothesis that timing of surgery in relation to last menstrual cycle date has any influence on patient OS and DFS, but we recommend further prospective studies in which cycle phase at time of tumor excision is biochemically documented.