[The influence of menopause on prognosis of breast cancer (author's transl)].
Between 1949 and 1968, 1369 female patients received primary treatment for breast cancer in the Robert-Rössle-Clinic of the Central Institute for Cancer Research of the Academy of Sciences of the GDR. Using a sequential procedure based on decision theory, the influence of menopause on prognosis of breast cancer was investigated in clinical stage I--III. The following rank order of negative prognostic signs was found in the 365 patients of 46-55 years age (5-year survival rate in braquets): skin involved beyond breast (0%); inflammatory type of cancer (0%); fixation of chest wall (0%); radiation treatment only (10%); tumor diameter in surgical specimen 5 cm and more (26%); tumor diameter 10+ cm by clinical examination (31%); skin ulceration (0%); axillary lymph nodes considered to contain growth (40%); menopause (59.7%). 85% of menstrating patients without these adverse prognostic signs survived for more than 5 years. Taking into consideration other observations, it is suggested that breast cancer before menopause is mostly oestrogen-dependent. When the ovary ceases to produce oestrogens in the next future, the cancer looses hormonal stimuli necessary for growth. This interpretation is in agreement with the observations that younger menstruating women show a definitely worse prognosis (5-year survival rate 55,8%). In controlled clinical trials, patients before and after menopause should be randomized separately.
D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality*; D004967:Estrogens; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D011379:Prognosis
D004967:Estrogens
Bedeutung der Menopause für die Prognose des Brustdrüsenkrebses