The Relationship between Surgery and Phase of the Menstrual Cycle Affects Survival in Breast Cancer

Küçük, Ali; Atalay, Can

doi:10.4048/jbc.2012.15.4.434

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…For this reason, women prescribed antidepressants such as fluoxetine require a lower dose while taking oral contraceptives because higher doses result in drug accumulation in the body (Damoiseaux et al, ). Menstrual cycle phase may be an important consideration for treating breast cancer; survival after curative surgery is most effective in the luteal phase of the menstrual cycle (Kucuk and Atalay, ). Manipulation of ovarian hormones, such as ovarian hormone withdrawal from hormones simulated pregnancy, can also be used to induce depressive‐like phenotypes in female rats (Galea et al, ).…”

Section: Studying Women (And Men): Influence Of Puberty Aging and Rmentioning

confidence: 99%

Sex, hormones, and genotype interact to influence psychiatric disease, treatment, and behavioral research

Gobinath

Choleris

Galea

2016

J of Neuroscience Research

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Sex differences exist in the vulnerability, incidence, manifestation, and treatment of numerous neurological and psychiatric diseases. Despite this observation prominent in the literature, little consideration has been given to possible sex differences in outcome in both preclinical and clinical research. This Mini-Review highlights evidence supporting why studying sex differences matter for advances in brain health as well as improving treatment for neurological and psychiatric disease. Additionally, we discuss some statistical and methodological considerations in evaluating sex differences as well as how differences in the physiology of the sexes can contribute to sex difference in disease incidence and manifestation. Furthermore, we review literature demonstrating that the reproductive experience in the female can render the female brain differentially vulnerable to disease across age. Finally, we discuss how genes interact with sex to influence disease risk and treatment and argue that sex must be considered in precision medicine. Together the evidence reviewed here supports the inclusion of males and females at all levels of neuroscience research. V C 2016 Wiley Periodicals, Inc.

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Section: Studying Women (And Men): Influence Of Puberty Aging and Rmentioning

confidence: 99%

Sex, hormones, and genotype interact to influence psychiatric disease, treatment, and behavioral research

Gobinath

Choleris

Galea

2016

J of Neuroscience Research

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“…Differences in classification methods can introduce significant variability into results, and may provide some explanation for the differences in results between different studies (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)26,27) (Table I). Other factors include inaccuracies in menstrual cycle data, as there can be significant variability in cycle length (i.e., 22-36 days) between women (35); and other factors, such as irregular menses, use of oral contraceptives, recent pregnancies, or differing hormonal and chemotherapy treatment regimens may impact circulating ovarian hormones and menstrual cycle phase.…”

Section: Confounding Factors That Could Affect the Relationship Betwementioning

confidence: 99%

“…Mouse studies supported by small retrospective clinical studies suggested that changes in the characteristics of the tumour and tumour microenvironment across the menstrual cycle might influence the metastatic potential of tumour cells, and affect clinical outcomes in premenopausal women. However, while some studies suggest that surgery performed during the luteal phase results in favourable outcomes in terms of metastatic incidence, disease free survival, and overall survival (6)(7)(8)(9)(10)(11)(12)(13)(14), other studies report the follicular phase is more favourable (5,15,16), and other studies show no association (17)(18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

Timing of breast cancer surgery during the menstrual cycle‑is there an optimal time of the month? (Review)

et al. 2020

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An intriguing relationship between menstrual cycle phase at the time of breast cancer surgery and clinical outcomes was first proposed in the late 1980s. Despite a number of clinical studies conducted to address this, as well as meta-analyses and systematic reviews, there remains significant controversy surrounding the effect of menstrual cycle phase at time of surgery on the prognosis of premenopausal breast cancer. While some studies have suggested that surgery performed during the luteal phase results in the most favourable outcome, other studies report the follicular phase is more favourable, and others show no association. Given the conflicting results, there remains insufficient evidence to determine whether there is an optimal time of the month to perform surgery. This issue has dogged breast cancer surgery for decades; knowledge of an optimal time of the month to conduct surgery would be a simple approach to improving patient outcomes. This review explores the potential biological mechanisms through which the hormonal milieu might contribute to differences in prognosis, and why clinical findings are so variable. It is concluded that a significant problem with current clinical research is the lack of insight from mechanistic studies. While there are a number of plausible biological mechanisms that could lead to altered survival, supporting evidence is limited. There are also variable approaches to defining the menstrual cycle phase and hormone receptor status of the tumour and few studies controlled for prognostic factors such as tumour size and stage, or addressed the impact of adjuvant treatments. Elucidation of the specific confounding factors, as well as biological mechanistic pathways that could explain the potential relationship between timing of surgery and survival, will greatly assist in designing robust well-controlled prospective clinical studies to evaluate this paradigm.

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“…More recently, a systematic review and meta-analysis found the literature on the matter to be inconclusive, but noted that the studies supporting the benefits of surgery in the luteal phase were generally more robust, with larger cohorts and longer follow-up times [52]. One such prospective study reported decreased DFS when surgeries were scheduled in the follicular phase of the menstrual cycle [53]. This effect was independent of the hormone receptor status of the tumors, indicating that the effect was not due to an intrinsic susceptibility of the tumors themselves to fluctuating hormone levels.…”

Section: Plos Onementioning

confidence: 99%

Serum IL-1RA levels increase from follicular to luteal phase of the ovarian cycle: A pilot study on human female immune responses

et al. 2020

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The immune responses exhibited by females are distinct from those of males. Females are known to generate, among others, higher levels of antibodies, greater interferon responses, and increased levels of inflammatory mediators in response to pathogens. Mounting evidence suggests that gonadal hormones play a key role in these differences. To better understand the effect of cycling hormones on the immune response, we sought to investigate the relationship between gonadal hormone fluctuations during the ovarian cycle and the levels of interleukin 1β and IL-1RA, both in circulation and in PBMCs in response to TLR4 stimulation, in healthy premenopausal females. To do this we measured the gonadal hormones 17β-estradiol, progesterone, and luteinizing hormone, and the cytokines IL-1β and IL-1RA in nine cycling females at several time points throughout one complete cycle. We evaluated 35 follicular, 17 ovulatory, and 44 luteal time points in our cohort and found a clear increase in serum levels of anti-inflammatory IL-1RA in the luteal phase, as compared to the follicular phase, and a positive correlation between both 17β-estradiol and progesterone and IL-RA. There was no difference in the serum levels of IL-1β and no difference in IL-1 β or IL-1RA produced in response to LPS by PBMCs isolated from different phases. Division of the cycle into sub-phases revealed an increase in the level of IL-1RA by ovulation that persisted through the luteal phase. These data suggest that significant changes in the immune response occur throughout the ovarian cycle in healthy females.

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The Relationship between Surgery and Phase of the Menstrual Cycle Affects Survival in Breast Cancer

Cited by 9 publications

References 15 publications

Sex, hormones, and genotype interact to influence psychiatric disease, treatment, and behavioral research

Sex, hormones, and genotype interact to influence psychiatric disease, treatment, and behavioral research

Timing of breast cancer surgery during the menstrual cycle‑is there an optimal time of the month? (Review)

Serum IL-1RA levels increase from follicular to luteal phase of the ovarian cycle: A pilot study on human female immune responses

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