Menstrual cycle and surgical treatment of breast cancer: Findings from the NCCTG N9431 study

Clive S. Grant, James N. Ingle, Vera Jean Suman, Daniel A. Dumesic, D. Lawrence Wickerham, Richard D. Gelber, Patrick J. Flynn, Lorna M. Weir, Mattia Intra, Wayne O. Jones, Edith A. Perez, Lynn C. Hartmann

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: For nearly two decades, multiple retrospective reports, small prospective studies, and meta-analyses have arrived at conflicting results regarding the value of timing surgical intervention for breast cancer on the basis of menstrual cycle phase. We present the results of a multi-cooperative group, prospective, observational trial of menstrual cycle phase and outcome after breast cancer surgery, led by the North Central Cancer Treatment Group (NCCTG) in collaboration with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the International Breast Cancer Study Group (IBCSG). Patients and Methods: Premenopausal women age 18 to 55 years, who were interviewed for menstrual history and who were surgically treated for stages I to II breast cancer, had serum drawn within 1 day of surgery for estradiol, progesterone, and luteinizing hormone levels. Menstrual history and hormone levels were used to determine menstrual phase: luteal, follicular, and other. Disease-free survival (DFS) and overall survival (OS) rates were determined by Kaplan-Meier method and were compared by using the log-rank test and Cox proportional hazard modeling. Results: Of 1,118 women initially enrolled, 834 women comprised the study cohort: 230 (28%) in luteal phase; 363 (44%) in follicular phase; and 241 grouped as other. During a median follow-up of 6.6 years, and in analysis that accounted for nodal disease, estrogen receptor status, adjuvant radiation therapy or chemotherapy, neither DFS nor OS differed with respect to menstrual phase. The 5-year DFS rates were 82.7%, 82.1%, and 79.2% for follicular, luteal, or other phases, respectively. Corresponding OS survival rates were 91.9%, 92.2%, and 91.8%, respectively. Conclusion: When menstrual cycle phases were strictly defined, neither DFS nor OS differed between women who underwent surgery during the follicular phase versus the luteal phase. Nearly 30% of the patients did not meet criteria for either follicular- or luteal-phase categories.

Original languageEnglish (US)
Pages (from-to)3620-3626
Number of pages7
JournalJournal of Clinical Oncology
Volume27
Issue number22
DOIs
StatePublished - Aug 1 2009

Fingerprint

Luteal Phase
Menstrual Cycle
Disease-Free Survival
Follicular Phase
Breast Neoplasms
Survival Rate
Survival
Neoplasms
Corpus Luteum
Therapeutics
Luteinizing Hormone
Ambulatory Surgical Procedures
Estrogen Receptors
Progesterone
Meta-Analysis
Estradiol
Breast
Cohort Studies
Radiotherapy
Hormones

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Grant, C. S., Ingle, J. N., Suman, V. J., Dumesic, D. A., Wickerham, D. L., Gelber, R. D., ... Hartmann, L. C. (2009). Menstrual cycle and surgical treatment of breast cancer: Findings from the NCCTG N9431 study. Journal of Clinical Oncology, 27(22), 3620-3626. https://doi.org/10.1200/JCO.2008.21.3603

Menstrual cycle and surgical treatment of breast cancer : Findings from the NCCTG N9431 study. / Grant, Clive S.; Ingle, James N.; Suman, Vera Jean; Dumesic, Daniel A.; Wickerham, D. Lawrence; Gelber, Richard D.; Flynn, Patrick J.; Weir, Lorna M.; Intra, Mattia; Jones, Wayne O.; Perez, Edith A.; Hartmann, Lynn C.

In: Journal of Clinical Oncology, Vol. 27, No. 22, 01.08.2009, p. 3620-3626.

Research output: Contribution to journalArticle

Grant, CS, Ingle, JN, Suman, VJ, Dumesic, DA, Wickerham, DL, Gelber, RD, Flynn, PJ, Weir, LM, Intra, M, Jones, WO, Perez, EA & Hartmann, LC 2009, 'Menstrual cycle and surgical treatment of breast cancer: Findings from the NCCTG N9431 study', Journal of Clinical Oncology, vol. 27, no. 22, pp. 3620-3626. https://doi.org/10.1200/JCO.2008.21.3603
Grant, Clive S. ; Ingle, James N. ; Suman, Vera Jean ; Dumesic, Daniel A. ; Wickerham, D. Lawrence ; Gelber, Richard D. ; Flynn, Patrick J. ; Weir, Lorna M. ; Intra, Mattia ; Jones, Wayne O. ; Perez, Edith A. ; Hartmann, Lynn C. / Menstrual cycle and surgical treatment of breast cancer : Findings from the NCCTG N9431 study. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 22. pp. 3620-3626.
@article{794702ff8eba464597f39f33b7ee72e8,
title = "Menstrual cycle and surgical treatment of breast cancer: Findings from the NCCTG N9431 study",
abstract = "Purpose: For nearly two decades, multiple retrospective reports, small prospective studies, and meta-analyses have arrived at conflicting results regarding the value of timing surgical intervention for breast cancer on the basis of menstrual cycle phase. We present the results of a multi-cooperative group, prospective, observational trial of menstrual cycle phase and outcome after breast cancer surgery, led by the North Central Cancer Treatment Group (NCCTG) in collaboration with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the International Breast Cancer Study Group (IBCSG). Patients and Methods: Premenopausal women age 18 to 55 years, who were interviewed for menstrual history and who were surgically treated for stages I to II breast cancer, had serum drawn within 1 day of surgery for estradiol, progesterone, and luteinizing hormone levels. Menstrual history and hormone levels were used to determine menstrual phase: luteal, follicular, and other. Disease-free survival (DFS) and overall survival (OS) rates were determined by Kaplan-Meier method and were compared by using the log-rank test and Cox proportional hazard modeling. Results: Of 1,118 women initially enrolled, 834 women comprised the study cohort: 230 (28{\%}) in luteal phase; 363 (44{\%}) in follicular phase; and 241 grouped as other. During a median follow-up of 6.6 years, and in analysis that accounted for nodal disease, estrogen receptor status, adjuvant radiation therapy or chemotherapy, neither DFS nor OS differed with respect to menstrual phase. The 5-year DFS rates were 82.7{\%}, 82.1{\%}, and 79.2{\%} for follicular, luteal, or other phases, respectively. Corresponding OS survival rates were 91.9{\%}, 92.2{\%}, and 91.8{\%}, respectively. Conclusion: When menstrual cycle phases were strictly defined, neither DFS nor OS differed between women who underwent surgery during the follicular phase versus the luteal phase. Nearly 30{\%} of the patients did not meet criteria for either follicular- or luteal-phase categories.",
author = "Grant, {Clive S.} and Ingle, {James N.} and Suman, {Vera Jean} and Dumesic, {Daniel A.} and Wickerham, {D. Lawrence} and Gelber, {Richard D.} and Flynn, {Patrick J.} and Weir, {Lorna M.} and Mattia Intra and Jones, {Wayne O.} and Perez, {Edith A.} and Hartmann, {Lynn C.}",
year = "2009",
month = "8",
day = "1",
doi = "10.1200/JCO.2008.21.3603",
language = "English (US)",
volume = "27",
pages = "3620--3626",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "22",

}

TY - JOUR

T1 - Menstrual cycle and surgical treatment of breast cancer

T2 - Findings from the NCCTG N9431 study

AU - Grant, Clive S.

AU - Ingle, James N.

AU - Suman, Vera Jean

AU - Dumesic, Daniel A.

AU - Wickerham, D. Lawrence

AU - Gelber, Richard D.

AU - Flynn, Patrick J.

AU - Weir, Lorna M.

AU - Intra, Mattia

AU - Jones, Wayne O.

AU - Perez, Edith A.

AU - Hartmann, Lynn C.

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Purpose: For nearly two decades, multiple retrospective reports, small prospective studies, and meta-analyses have arrived at conflicting results regarding the value of timing surgical intervention for breast cancer on the basis of menstrual cycle phase. We present the results of a multi-cooperative group, prospective, observational trial of menstrual cycle phase and outcome after breast cancer surgery, led by the North Central Cancer Treatment Group (NCCTG) in collaboration with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the International Breast Cancer Study Group (IBCSG). Patients and Methods: Premenopausal women age 18 to 55 years, who were interviewed for menstrual history and who were surgically treated for stages I to II breast cancer, had serum drawn within 1 day of surgery for estradiol, progesterone, and luteinizing hormone levels. Menstrual history and hormone levels were used to determine menstrual phase: luteal, follicular, and other. Disease-free survival (DFS) and overall survival (OS) rates were determined by Kaplan-Meier method and were compared by using the log-rank test and Cox proportional hazard modeling. Results: Of 1,118 women initially enrolled, 834 women comprised the study cohort: 230 (28%) in luteal phase; 363 (44%) in follicular phase; and 241 grouped as other. During a median follow-up of 6.6 years, and in analysis that accounted for nodal disease, estrogen receptor status, adjuvant radiation therapy or chemotherapy, neither DFS nor OS differed with respect to menstrual phase. The 5-year DFS rates were 82.7%, 82.1%, and 79.2% for follicular, luteal, or other phases, respectively. Corresponding OS survival rates were 91.9%, 92.2%, and 91.8%, respectively. Conclusion: When menstrual cycle phases were strictly defined, neither DFS nor OS differed between women who underwent surgery during the follicular phase versus the luteal phase. Nearly 30% of the patients did not meet criteria for either follicular- or luteal-phase categories.

AB - Purpose: For nearly two decades, multiple retrospective reports, small prospective studies, and meta-analyses have arrived at conflicting results regarding the value of timing surgical intervention for breast cancer on the basis of menstrual cycle phase. We present the results of a multi-cooperative group, prospective, observational trial of menstrual cycle phase and outcome after breast cancer surgery, led by the North Central Cancer Treatment Group (NCCTG) in collaboration with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the International Breast Cancer Study Group (IBCSG). Patients and Methods: Premenopausal women age 18 to 55 years, who were interviewed for menstrual history and who were surgically treated for stages I to II breast cancer, had serum drawn within 1 day of surgery for estradiol, progesterone, and luteinizing hormone levels. Menstrual history and hormone levels were used to determine menstrual phase: luteal, follicular, and other. Disease-free survival (DFS) and overall survival (OS) rates were determined by Kaplan-Meier method and were compared by using the log-rank test and Cox proportional hazard modeling. Results: Of 1,118 women initially enrolled, 834 women comprised the study cohort: 230 (28%) in luteal phase; 363 (44%) in follicular phase; and 241 grouped as other. During a median follow-up of 6.6 years, and in analysis that accounted for nodal disease, estrogen receptor status, adjuvant radiation therapy or chemotherapy, neither DFS nor OS differed with respect to menstrual phase. The 5-year DFS rates were 82.7%, 82.1%, and 79.2% for follicular, luteal, or other phases, respectively. Corresponding OS survival rates were 91.9%, 92.2%, and 91.8%, respectively. Conclusion: When menstrual cycle phases were strictly defined, neither DFS nor OS differed between women who underwent surgery during the follicular phase versus the luteal phase. Nearly 30% of the patients did not meet criteria for either follicular- or luteal-phase categories.

UR - http://www.scopus.com/inward/record.url?scp=68949133135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68949133135&partnerID=8YFLogxK

U2 - 10.1200/JCO.2008.21.3603

DO - 10.1200/JCO.2008.21.3603

M3 - Article

C2 - 19487378

AN - SCOPUS:68949133135

VL - 27

SP - 3620

EP - 3626

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 22

ER -