The Chronobra identifies prevailing mammary vascularity as a candidate variable in breast cancer post-operative outcome prediction
1 University Department of Surgery, Royal Infirmary, Glasgow, G4 OSF, UK
2 University Department of Surgery, Western Infirmary, Glasgow, G11 6NT, UK
3 College of Biological Sciences, University of Minnesota, St. Paul, MN, USA
4 Tenovus Cancer Centre, College of Medicine, University of Wales, Cardiff, Wales, CF14 4XN, UK
5 University Department of Surgery, Royal Infirmary, Glasgow, G31 2ER, UK
SpringerPlus 2013, 2:241 doi:10.1186/2193-1801-2-241Published: 24 May 2013
We previously described a menstrual heat cycle of the breast in four groups of women (healthy, family history of breast cancer, benign breast disease, ‘cancer-associated’) who wore a thermometric brassiere (Chronobra). We now ask if ‘breast minus oral temperature’, indicating ‘breast-associated vascularity’, could be associated with breast cancer cell vascular access around different aspects of the menstrual cycle rhythm and survival. Thirty-six pre-menopausal breast cancer patients (average age: 38.97 y) were enrolled consecutively over 15 y and followed for more than 22 y after surgery in order to compare survival and peri-operative vascularity. Each subject wore the Chronobra, which provides an internal bioassay of the vascularity of both breasts, including the operated breast, during 1 h each evening at home for one menstrual cycle, and collected saliva for “free” progesterone to confirm pre-menopausal status and ovulation. Sixty-five healthy age-matched pre-menopausal women served as controls. Both oral and breast temperatures revealed menstrual cycle oscillations, rising just before ovulation until menses onset. Breast-adjusted vascularity also showed menstrual cycle oscillations, with levels differing significantly between the 3 groups during the luteal phase only. At the end of the follow-up span, 18 post-operative breast cancer patients had died from “disseminated” breast cancer and 18 were alive and well. Median follow-up time was 22.6 y for survivors, 6.2 y for non-survivors, and 21.0 y for controls (3 died from diseases unrelated to breast cancer). Based on ‘during luteal-phase breast-adjusted vascularity’, breast cancer survivors (mean ± SD: -1.65 ± 0.23°C) were significantly hypo-vascular (i.e., -0.23°C cooler) compared with controls (-1.42 ± 0.09°C), while non-survivors (-1.25 ± 0.12°C) were highly significantly hyper-vascular compared with survivors (+0.41°C warmer) and controls (+0.23°C warmer). This suggests that in pre-menopausal breast cancer patients, peri-operative mammary vascularity could offer an outcome test of survival and biologically may be on the “final common pathway” of any tumor to metastatic risk and recurrence.