# Single-injection depot progesterone before surgery and survival in operable breast cancer

Source: https://onco.cc/key-papers/paper-badwe-progesterone-jco-2011/  
OnCo record `paper-badwe-progesterone-jco-2011` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A single cheap hormone injection given days before breast surgery did not help every patient, but among women whose cancer had spread to lymph nodes it improved five-year survival, a result that seeded twenty years of low-cost perioperative trials in India.

## Summary

976 women with operable breast cancer at Tata Memorial were randomised to one intramuscular injection of depot hydroxyprogesterone 5 to 14 days before surgery or to surgery alone, with a median follow-up of 65 months. Disease-free and overall survival were not significantly different overall. In node-positive women, 5-year disease-free survival was 65.3% versus 54.7% (hazard ratio 0.72; 95% CI 0.54-0.97; P=0.02) and overall survival 75.7% versus 66.8% (hazard ratio 0.70; 95% CI 0.49-0.99; P=0.04).

## Fields

- Kind: Key paper
- Last checked: 2026-09-10
- Journal: Journal of Clinical Oncology
- Year: 2011
- DOI: 10.1200/JCO.2010.33.0738
- Authors: Badwe R, Hawaldar R, Parmar V, et al.
- Findings: No significant overall improvement in disease-free or overall survival.; Node-positive subgroup: 5-year disease-free survival 65.3% versus 54.7% (HR 0.72).; Node-positive subgroup: 5-year overall survival 75.7% versus 66.8% (HR 0.70).; Intervention cost is a single injection of a generic hormone.
- What it means: The trial did not change practice, but it established the idea that the days around surgery are a window in which cheap interventions might reduce metastasis, a line the same group pursued to a positive result with peritumoral lidocaine in 2023. It is a reminder that subgroup findings need confirmation, which is still awaited.
- Caveats: The benefit is a subgroup finding in a trial whose primary analysis was negative.; Mechanism (progesterone-driven changes in tumour gene expression) is plausible but unproven in humans.; No confirmatory trial has yet reported.

## Sources

- JCO 2011: https://doi.org/10.1200/JCO.2010.33.0738

## Connected records

- cancers: [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/)
- technologies: [Endocrine therapy (SERMs, AIs, SERDs)](https://onco.cc/technologies/endocrine-therapy/)
- institutions: [Tata Memorial Centre](https://onco.cc/institutions/tata-memorial/)
- trials: [Peritumoral lidocaine before breast cancer surgery (Tata Memorial)](https://onco.cc/trials/lidocaine-peritumoral-tmh/), [Single-injection depot progesterone before breast surgery (Tata Memorial)](https://onco.cc/trials/progesterone-preop-tmh/)
- people: [Rajendra Badwe](https://onco.cc/people/badwe-rajendra/)
- bottlenecks: [No incentive to repurpose cheap drugs](https://onco.cc/bottlenecks/b-generic-repurposing/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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