Dr Paul Layman wrote to us to clear up an error in the Tony Howell interview. Paul writes, "An eighteen year study on the protective effect of natural progesterone has recently been confirmed. The oestrogen receptor status of breast cancer is now thought to be of significance in recurrence rates, but the Imperial College study seemed to suggest that the timing of breast surgery was more important than receptor status".

And he is perfectly correct. Choosing the correct point in your monthly cycle to have a breast operation can increase your 10-year survival chances by two thirds! Every woman and their doctor should know this fact.

The Imperial Cancer Research Fund (Cancer, 15 Nov 1999) states clearly that "Women having breast tumours removed during the follicular phase of their cycle (that is days 3-12 when their oestrogen is high) have a 10-year survival rate of only 45 per cent, compared to a 10-year survival rate of 75 per cent for women having surgery during the luteal phase (when progesterone is high)."

Indeed the research also showed that oestrogen receptor positive and progesterone receptor positive tumours had the highest survival rates if surgery was performed in the second half of a woman's cycle.

This work confirmed an earlier study from Guy's Hospital by Cooper, Gillett, Patel, Barnes and Fentiman in August 1999 and yet earlier work by Hrushesky et al (Lancet 1989).

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