PREDICTION OF RECURRENCE IN OPERABLE BREAST-CANCER BY POSTOPERATIVE CHANGES IN PROLACTIN SECRETION

It has been demonstrated that breast surgery may induce prolactin (PRL ) increase. Because of the potential stimulatory role of PRL on breast cancer cells, its postoperative increase may influence the prognosis of breast cancer patients. This study was performed to evaluate the in fluence of surgery-induced hyperprolactinemia on recurrence rate in op erable breast cancer. The study included 250 consecutive breast cancer patients, clinical stage T1-3 N0-2M0, who were observed for a median follow-up of 72 months. Surgery-induced hyperprolactinemia occurred in 108/250 patients (43 %). Irrespectively of node involvement, hormonal receptor, type of surgery and adjuvant therapies, the relapse rate wa s significantly higher in patients who had no surgery-induced hyperpro lactinemia than in those with postoperative PRL increase (64/142 vs. 2 3/108; p < 0.001). This difference was also significant in relation to node status (N0: 22/63 vs. 5/56, p < 0.001; N+: 42/79 vs. 18/52, p < 0.05). The present study shows that a surgery-induced rise of PRL, des pite its potential stimulation of cancer cell growth, is paradoxically associated with a longer disease-free survival in operable breast car cinoma in both patients with or without axillary node involvement. Mor eover, this study suggests that the prognosis of node-negative patient s who did not show postoperative hyperprolactinemia tends to be simila r to that of patients with node involvement and surgery-induced PRL en hancement. Therefore, the lack of surgery-induced hyperprolactinemia w ould have to be grouped together with the unfavorable prognostic facto rs of breast cancer.