Prompted by a report of Hrushesky et al. stating that women operated upon for breast cancer during their perimenstrual period showed a higher risk for developing future metastases than women operated upon during their mid-cycle, we examined the patients with breast carcinoma who were treated at the Gynaecological University Hospital Zürich between 1971 and 1988 with respect to the influence of menstrual cycle phase on certain factors. 104 patients underwent perimenstrual surgery, i.e., between days 1 and 6 or days 21 and 36 of the cycle. 120 women had mid-cycle surgery (i.e., days 7-20 of the cycle). In contrast to the experience of Hrushesky et al., we found no significant differences in the survival curves. The same was true when the proliferative phase (days 1-14; n = 109) was compared with the secretory phase (days 15-32; n = 108). We tested the different groups for homogeneity and found that 54% of the patients with perimenstrual surgery showed axillary lymph node involvement, whereas in the midcyclic group only 38% showed positive nodes. We have no plausible explanation for this difference. These findings indicate that there might be certain cycle-related differences with respect to lymph node status but that they do not affect survival. Hence, timing surgery to the menstrual cycle is not mandatory for the time being.

Since January 1, 1983 a total of 250,000 patient records have been stored in computer-compatible form in the data base of the Working Group of Swiss Gynecologic Clinics (59 gynecologic-obstetric departments). The information resulting from this mass of data is commented on and analyzed in concise form. Problems of quality control, health care and status-related policies can be addressed and resolved on the basis of up-to-date data which are always available. In the authors' experience, the benefit of correctly compiled statistics is indisputable.

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Thanks to the statistics of the Arbeitsgemeinschaft Schweizerischer Frauenkliniken (Swiss Gynecological Clinics' Working Group) it has for the first time become possible to report on larger numbers of laparoscopies performed in Switzerland. In contrast to most international statistical records, data relating to this subject are gathered prospectively; there is no doubt that this improves the quality of the data. The authors report on a total of 18,186 laparoscopies performed in 1983/84/85, in 50% of the cases for sterilization. The various sterilization methods employed are discussed. As far as diagnostic laparoscopies are concerned, the indications and techniques are described. Serious intraoperative complications occurred in 15 cases, which corresponds to one serious complication in every 1,212 laparoscopies. Fortunately, not a single patient died as a direct result of the laparoscopy. The results are compared with those in the international literature. With regard to late-onset morbidity it is evident that there are more complications with the more complex procedure of diagnostic laparoscopy.