Adrenalectomy in the treatment of incurable carcinoma of the breast in five hundred consecutive patients
Sharma, R.; Ashikari, R.; Fracchia, A.A.
Surgery Gynecology and Obstetrics 151(2): 177-181
1980
ISSN/ISBN: 0039-6087 PMID: 6250240 Document Number: 155047
Women (500) with primary inoperable or recurrent carcinoma of the breast were treated by adrenalectomy or combined oophoro-adrenalectomy. The objective response rate for 6 mo. or longer was 38.5% with a reduction in mortality to 3.8%. This difference is due to better selection of the patients. Prophylactic use of chemotherapy has substantially increased the disease-free interval and has increased the number of women suitable for hormonal manipulation. Cancer limited to nonvital areas such as soft tissues and bones, response to castration in actively menstruating women, and remissions to antiestrogens or medical treatment after adrenalectomy, are additional favorable criteria in selecting patients likely to respond. When both estrogen and progesterone receptors are positive, a better than 80% response rate is noted subsequent to extensive ablative endocrine procedures. The discovery of new receptors and elevated levels of circulating hormones may help in determining those patients who will have a prolonged remission and make these extensive operative procedures worthwhile.