SERUM PROLACTIN LEVELS AND THEIR RELATIONSHIP TO SURVIVAL IN WOMEN WITH OPERABLE BREAST-CANCER

The prognostic value of serum prolactin levels was assessed in a seque ntial series of 739 patients who were initially treated at Guy's Hospi tal, London, between 1975 and 1980. Prolactin was measured in 472 pati ents 1 day before (Hpr1) and in 457 patients 10 days after (Hpr2) mast ectomy. Follow-up of the patients was up to August 1992 giving 6139 wo men-years with a median follow-up time of 11.5 years (13.7 for patient s still living and 5.1 for those dead). The association between the th ree prolactin variables and reproductive and clinical factors was exam ined before assessing the prognostic value of prolactin levels in term s of overall, disease-specific and disease-free survival. Multivariate survival models were used in order to adjust for the effect of other prognostic variables. These were found to be: tumour size, degree of n odal involvement, tumour grade and age at diagnosis. The results showe d that high Hpr2 or high postoperative increase in prolactin (i.e. Hpr 2 -Hpr1) were significantly related to shorter disease-specific surviv al (p = 0.04 and 0.01, respectively) in postmenopausal women. In addit ion there was some indication, which did not attain formal significanc e, for this association to occur for disease-free survival. Thus the r ise in blood prolactin levels after surgery may be a weak indicator of poor prognosis of breast cancer in postmenopausal women.