Correspondence to: John S. Spratt, M.D., Division of Surgical Oncology, Brown Cancer Center, University of Louisville, 529 S. Jackson St., Rm. 317, Louisville, KY 40202-1671 (fax: 502-583-4369).
With respect to the report by White et al. (1) that discussed the variation in mammographic breast density by time in the menstrual cycle among women aged 40-49 years, in addition to the authors' recommendation that mammograms be performed during the first 2 weeks after menses when the breasts are less dense, there is an additional hypothetical reason why the breasts should not be exposed to radiation therapy during the progestational phase of the menstrual cycle (generally the 2 weeks before menstruation). As Meyer et al. (2) have shown, the breast ductal cells cycle with the menstrual cycle and a greater proportion are in the G2 phase during the progestational phase of the menstrual cycle. If radiation therapy is to induce a carcinogenic mutation, it would have to do so when the ductal cells are in the G2 phase. Also, the breasts are more tender during the progestational phase, adding to the discomfort of compression from the mammograms.
REFERENCES
1
White E, Velentgas P, Mandelson MT, Lehman CD, Elmore JG,
Porter P, et al. Variation in mammographic breast density by time in menstrual cycle among
women aged 40-49 years. J Natl Cancer Inst 1998;90:906-10.
2 Meyer JS. Cell proliferation in normal human breast ducts, fibroadenomas, and other ductal hyperplasias measured by nuclear labeling with tritiated thymidine: effects of menstrual phase, age, and oral contraceptive hormones. Hum Pathol 1977;8:67-81.[Medline]
Editor's note: The authors of the original paper (1) declined to respond.
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