UNOPPOSED ESTROGEN AND SURVIVAL OF BREAST-CANCER

It has been suggested that survival of breast cancer patients may be a ffected by their hormonal milieu. the level of circulating oestrogen i n a woman's body changes with the phase of menstrual cycle, the amount of body fat and her menopausal status. We examined whether these fact ors affect survival from breast cancer. Meta-analysis of relevant lite rature for age (reflecting menopausal status; 22 studies), timing of s urgery during the menstrual cycle in premenopausal women (28 studies) and body weight in postmenopausal women (18 studies), was carried out to determine the effect of unopposed oestrogen at the time of surgery on survival in breast cancer. The meta-analyses revealed a significant ly better survival in premenopausal vs postmenopausal patients (OR 0.7 6, CI 0.74-0.78, 2P < 0.0000001), in patients who were operated in the luteal vs follicular phase of the menstrual cycle (OR 0.87, CI 0.79-0 .97, 2P < 0.02), and in postmenopausal women who were not obese vs obe se (OR 0.64, CI 0.59-0.70 2P < 0.0000001). These data indicate that un opposed oestrogen at the time of surgery may have a deleterious effect on survival in women of all ages. It prompts future research into cha nging the hormonal milieu at the time of surgery as a means of improvi ng survival.