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Timing Of Breast Cancer Surgery Doesn't Appear To Influence Survival Anymore

Is it possible that young women with breast cancer live longer if the operation to remove the cancer is performed during the middle of the menstrual cycle rather than at the beginning? The answer depends on how long ago the surgery was done. Prior to 1984, surgery done during the onset of menstruation almost doubled the risk of dying compared to surgery around the time of ovulation, according to the results of a new study led by a New York University School of Medicine researcher.

The study, led by Susan Harlap, M.D., Research Professor of Epidemiology in the Department of Obstetrics and Gynecology at NYU School of Medicine, examines the notion that timing breast cancer surgery to a particular phase of the menstrual cycle influences subsequent survival.

"This is an enormously controversial subject," says Dr. Harlap. "Our new data has shown that the timing of surgery influenced survival for women diagnosed with breast cancer in the late 1970s and early 1980s. But is it still important? We don't know, but the answer seems to be no. In the mid-1980s, something changed. From 1984 to 1988, the latest date covered by our study, the timing of surgery in the menstrual cycle has been unimportant.

"Right now we don't advocate scheduling breast cancer surgery on any particular day of the menstrual cycle," she says.

What might have changed in medical practice? Harlap points out that not only have surgical practice and chemotherapy changed, but so also have the drugs used for the anesthetic, as well as for post-operative pain control. "Patients are now kept warmer during the operation, fewer need blood transfusions and infection control has improved," she says. Harlap and her colleagues speculate that any one of these changes may have benefited breast cancer patients, as they are known to influence survival in other kinds of cancer.

Some previous studies have shown that surgery during the first half of
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Contact: Marjorie Shaffer
Marjorie.Shaffer@med.nyu.edu
212.263.5488
New York University Medical Center and School of Medicine
30-Jun-1998


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