

Timing may improve results
in breast cancer surgeriesMay 1, 1996
Web posted at: 7:35 a.m. EDTFrom Correspondent Dan Rutz
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HOUSTON, Texas (CNN) -- In Italy, a group of researchers from the European Institute of Oncology is studying the effects of timing breast cancer surgery to coincide with the second half of the woman's menstrual cycle.
So far, they have reviewed more than a thousand cases. In half of the cases, the women had timed surgery; the other half did not. Their preliminary conclusion is that timing the operation appears to make a difference.
The fear of relapse is a common one for breast cancer patients, and a reasonable one. After surgery, nearly every breast cancer patient asks her doctor if all the cancer cells are gone. Even the best surgeons often have to answer vaguely -- "I think so," or, "It looks good." Cancer cells left behind can be swept into the blood stream and grow into new tumors.
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Dr. Umberto Veronesi believes that timing the surgery can help prevent the cancer's return. He presented the Italian study at the M.D. Anderson Breast Disease Conference in Houston this week, and said of his group's study, "At five years, the survival was 75 percent in (the timed) group and 66 percent for the other group." Women in the timed group were not only alive, but apparently cancer-free.
Veronesi says his researchers have come up with several explanations, all theoretical. Changes in hormones are the most likely explanation.
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But the difference in the two groups of patients could also be mere coincidence. Gary Clark is among the experts pointing to contradictory results from other studies.
"My reading of the literature, as I put all the data together, is that there is probably a small -- very small -- positive benefit, but not nearly as great as many of the proponents would want you to believe," Clark said.
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Over five years, Donna Brogan underwent three breast cancer operations. Her surgeries were not timed to her cycle. Now, she wishes they had been. "It is my gut feeling that there is something there," she said.
Yet even the proponents of timed surgery agree that more research is needed. The Italian group has begun what could be the best study yet into the issue. In the meantime, they say, it is up to women and their doctors to decide on a time for surgery that is most comfortable for them.
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