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Editorials |

The Optimal Timing of Mastectomy: Low Tide or High Tide?

William L. McGuire, MD
[+] Article and Author Information

Requests for Reprints: William L. McGuire, MD, University of Texas Health Science Center, Division of Medical Oncology, 7703 Floyd Curl Drive, San Antonio, TX 78284-7884.


University of Texas Health Science Center
San Antonio, TX 78284-7884


Ann Intern Med. 1991;115(5):401-403. doi:10.7326/0003-4819-115-5-401
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Frankly, I have been skeptical about the claims of chronobiologists that many important biologic phenomena in humans are regulated in no small way by earthly rhythms. These might include time of day or month, light and dark, phases of the moon, ocean tides, and so forth. As you can imagine, my interest was piqued when Hrushesky and colleagues published their provocative study of 41 premenopausal patients with breast cancer demonstrating that mastectomy done during the perimenstrual period (days 0 to 6 and 21 to 36 from the start of the last menstrual period) was associated with a higher subsequent recurrence

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