Breast Cancer

, Volume 5, Issue 1, pp 33–46 | Cite as

The role of hormonal therapy in breast cancer

  • Masakuni Noguchi
  • Koichi Miwa
Review Article


This review reassesses the role of hormonal therapy in breast cancer specifically the sequential or concurrent use of endocrine therapy and the combined use of chemotherapy with endocrine therapy. In advanced disease the sequential use of hormone therapies is generally recommended rather than the combined use of various hormonal agents, though combination hormonal therapy offers advantages in certain subsets of patients. The efficacy of combined chemo-endocrine therapy is questionable. Chemotherapy with estrogenic recruitment is an attractive but still experimental concept. However, in an adjuvant setting there is evidence that combined chemo-endocrine therapy causes a significant increase in disease-free and/or overall survival, particularly in postmenopausal patients with estrogen receptor (Expositive tumors. While hormonal treatment strategies have clearly benefitted from randomized studies, data regarding optimal endocrine therapy are still insufficient.


Breast cancer Hormonal therapy Randomized trial 







Estrogen receptor


Gonadotrophin releasing hormone




Megestrol acetate


Medro-xyprogesterone acetate


Progesterone receptor




Luteinizing hormone-releasing hormone


Cydophosphamide, 5-fluorouracil


Cyclophosphamide, methotrexate, 5-fluorouracil


Cyclophosphamide, epidoxorubicin, 5-fluorouracil


Cyclophosphamide, adriamycin, 5-fluorouracil


Cyclophosphamide, adriamycin, methotrexate, 5-fluorouracil








Disease-free survival


Overall survival




Adriamycin, cyclophosphamide


L-PAM, 5-fluorouracil




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  1. 1).
    Beatson GT: On the treatment of inoperable cases of carcinoma of the mamma; Suggestions for a new method of treatment with illustrative cases.Lancet 2:104–107, 1896.Google Scholar
  2. 2).
    Huggins C, Bergenstal DM: Inhibiton of human mammary and prostate cancers by adrenalectomy.Cancer Res 12:134–141, 1952.PubMedGoogle Scholar
  3. 3).
    Luft R, Olivecrona H: Hypophysectomy in man; Experiences in metastatic cancer of the breast.Cancer 8:261–270, 1955.PubMedGoogle Scholar
  4. 4).
    Henderson IC, Canellos GP: Cancer of the breast.N Engl J Med 302:17, 78–90, 1980.PubMedGoogle Scholar
  5. 5).
    Henderson IC: Endocrine therapy of metastatic breast cancer. In: Harris JR, Hellman S, Henderson IC, Kinne DW eds, Breast Diseases, 2nd ed, Lippincott, New York, pp559–603, 1991Google Scholar
  6. 6).
    Pritchard KI, Sutherland DJA: Diagnosis and therapy of breast cancer; The use of endocrine therapy.Hematol Oncol Clin North Am 3:765–805, 1989.PubMedGoogle Scholar
  7. 7).
    Muss HB: Endocrine therapy for advanced breast cancer; A review.Breast Cancer Res Treat 21:15–26, 1992.PubMedGoogle Scholar
  8. 8).
    Robin PE, Dalton GA: The role of major endocrine ablation. In: Stoll BA ed, Breast Cancer; Early and Late, Yearbook Medical Publisher, Chicago, ppl47–156, 1977.Google Scholar
  9. 9).
    Manni A: Tamoxifen therapy of metastatic breast cancer.J Lab Clin Med 109:290–299, 1987.PubMedGoogle Scholar
  10. 10).
    Santen RJ, Manni A, Harvey H,et al: Endocrine treatment of breast cancer in women.Endocr Rev 11:221–265, 1990.PubMedGoogle Scholar
  11. 11).
    Furr BJA, Woodburn JR: Luteinizing hormone-releasing hormone and its analogues; A review of biological properties and clinical uses.J Endocrinol Invest 11:535–557, 1988.PubMedGoogle Scholar
  12. 12).
    Murphy CAT, Jordan VC: Endocrine aspects of breast cancer. Bailliere’s Clinical Oncology 2(1) 1988, Bailliere’s Tindall, London, pp117–138.Google Scholar
  13. 13).
    Early Breast Cancer Trialists’ Collaborative Group: Ovarian ablation in early breast cancer; Overview of the randomised trials.Lancet 348:1189–1196, 1996.Google Scholar
  14. 14).
    Huggins C, Dao TLY: Adrenalectomy and oophorectomy in treatment of advanced carcinoma of the breast.JAMA 151:1388–1394, 1953.Google Scholar
  15. 15).
    Huggins C, Dao TLY: Characteristics of adrenal-dependent mammary cancers.Ann Surg 140:497–501, 1954.PubMedGoogle Scholar
  16. 16).
    Pearson OH, West CD, Hollander VP,et al: Evaluation of endocrine therapy for advanced breast cancer.JAMA 154:234–239, 1954.Google Scholar
  17. 17).
    Pearson OH, Ray BS, Harrold CC,et al: Hypophysectomy in treatment of advanced cancer.JAMA 161:17–21, 1956.Google Scholar
  18. 18).
    Buchanan RB, Blarney RW, Durrant KR,et al: A randomized comparison of tamoxifen with surgical oophorectomy in premenopausal patients with advanced breast cancer.J Clin Oncol 4:1326–1330, 1986.PubMedGoogle Scholar
  19. 19).
    Ingle JN, Krook JE, Green SJ,et al: Randomized trial of bilateral oophorectomy versus tamoxifen in premenopausal women with metastatic breast cancer.J Clin Oncol 4:178–185, 1986.PubMedGoogle Scholar
  20. 20).
    Nemoto T, Patel J, Rosner D,et al: Tamoxifen (Nolvadex) versus adrenalectomy in metastatic breast cancer.Cancer 53:1333–1335, 1984.PubMedGoogle Scholar
  21. 21).
    Kiang DT, Frenning DH, Vosika GJ,et al: Comparison of tamoxifen and hypophysectomy in breast cancer treatment.Cancer 45:1322–1325, 1980.PubMedGoogle Scholar
  22. 22).
    Santen RJ, Worgul TJ, Samojlik E,et al: A randomized trial comparing surgical adrenalectomy with amino-glutethimide plus hydrocortisone in women with advanced breast cancer.N Engl J Med 305:545–551, 1981.PubMedGoogle Scholar
  23. 23).
    Kaufmann M, Jonat W, Schachner-Wunschmann E,et al: The depot GnRH analogue goserelin in the treatment of premenopausal patients with metastatic breast cancer; A 5-year experience and further endocrine therapies.Onkologie 14:22–30, 1991.PubMedGoogle Scholar
  24. 24).
    Buckley MM, Goa KL: Tamoxifen; A reappraisal of its pharmacodynamic and phamarcokinetic properties, and therapeutic use.Drugs 37:451–490, 1989.PubMedGoogle Scholar
  25. 25).
    Cole MP, Jones CTA, Todd IDH: A new antioestrogenic agent in late breast cancer; An early clinical appraisal of ICI 46,474.Br J Cancer 25:270–275, 1971.PubMedGoogle Scholar
  26. 26).
    Ingle JN, Ahmann DL, Green SJ,et al: Randomized clinical trial of diethylstilbestrol versus tamoxifen in postmenopausal women with advanced breast cancer.N Engl J Med 304:16–21, 1981.PubMedGoogle Scholar
  27. 27).
    Stewart HJ, Forrest APM, Gunn JM,et al: The tamoxifen trial; A double-blind comparison with stilboestrol in postmenopausal women with advanced breast cancer. In: Mouridsen HT, Paulshof T eds, Breast Cancer; Experimental and Clinical Aspects, Pergamon Press, Oxford, pp83–88, 1980.Google Scholar
  28. 28).
    Van Veelen H, Willemse PHB, Tjabbes T,et al: Oral high-dose medroxyprogesterone acetate versus tamoxifen.Cancer 58:7–13, 1986.PubMedGoogle Scholar
  29. 29).
    Ingle JN, Ahmann DL, Green SJ: Randomized clinical trial of megestrol acetate versus tamoxifen in paramenopausal or castrated women with advanced breast cancer.Am J Clin Oncol 2:155–160, 1982.Google Scholar
  30. 30).
    Muss HB, Wells HB, Paschold EH,et al: Megestrol acetate versus tamoxifen in advanced breast cancer; 5-year analysis; A phase III trial of the Piedmont Oncology Association.J Clin Oncol 6:1098–1106, 1988.PubMedGoogle Scholar
  31. 31).
    Alonso-Munoz MC, Ojeda-Gonzalez MB, Beltran-Fabregat M,et al: Randomized trial of tamoxifen versus aminoglutethimide and versus combined tamoxifen and aminoglutethimide in advanced postmenopausal breast cancer.Oncology 45:350–353, 1988.PubMedGoogle Scholar
  32. 32).
    Smith IE, Harris AL, Morgan M,et al: Tamoxifen versus aminoglutethimide in advanced breast carcinoma; A randomised cross over trial.Br Med J 283:1432–1434, 1981.Google Scholar
  33. 33).
    Lipton A, Harvey HA, Santen RJ,et al: Randomized trial of aminoglutethimide versus tamoxifen in metastatic breast cancer.Cancer Res 42 (Suppl):3434s-3436s, 1982.PubMedGoogle Scholar
  34. 34).
    Kaufmann M, Jonat W, Kleeberg U,et al: Goserelin, a depot gonadotrophin-releasing hormone agonist in the treatment of premenopausal patients with breast cancer.J Clin Oncol 7:1113–1119, 1989.PubMedGoogle Scholar
  35. 35).
    Blarney RW, Jonat W, Kaufmann M,et al: Survival data relating to the use of goserelin depot in the treatment of premenopausal advanced breast cancer.Eur J Cancer 29A:1498, 1993.Google Scholar
  36. 36).
    Baum M, Brinkley DM, Dossett JA,et al: Controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer.Lancet i:836–840, 1985.Google Scholar
  37. 37).
    Nolvadex Adjuvant Trial Organisation: Controlled trial of tamoxifen as a single adjuvant agent in management of early breast cancer; Analysis at eight years by the Nolvadex Adjuvant Trial Organisation.Br J Cancer 57:608–611, 1988.Google Scholar
  38. 38).
    Breast Cancer Trials Committee: Adjuvant tamoxifen in the management of operable breast cancer; The Scottish trial.Lancet 2:171–175, 1987.Google Scholar
  39. 39).
    Ribeiro G, Swindell R: The Christie Hospital tamoxifen (Nolvadex) adjuvant trial for operable breast carcinoma; 7-year results.EurJ Cancer Clin Oncol 21:897–900, 1985.Google Scholar
  40. 40).
    Fisher B, Costantino J, Redmond Cet al: A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors.N Engl J Med 320:479–484, 1989.PubMedGoogle Scholar
  41. 41).
    Jaiyesimi IA, Buzdar AU, Decker DA,et al: Use of tamoxifen for breast cancer; Twenty-eight years later.J Clin Oncol 13:513–529, 1995.PubMedGoogle Scholar
  42. 42).
    Swedish Breast Cancer Cooperative Group: Randomized trial of two versus five years of adjuvant tamoxifen for postmenopausal early stage breast cancer.J Natl Cancer Inst 88:1543–1549, 1996.Google Scholar
  43. 43).
    Fisher B, Dignam J, Bryant J,et al: Five versus more than five years of tamoxifen therapy for breast cancer patients with negative lymph nodes and estrogen receptor-positive tumors.J Natl Cancer Inst 88:1529–1542, 1996.PubMedGoogle Scholar
  44. 44).
    Stewart HJ, Forrest AP, Everington D,et al: Randomised comparison of 5 years of adjuvant tamoxifen with continuous therapy for operable breast cancer.Br J Cancer 74:297–299, 1996.PubMedGoogle Scholar
  45. 45).
    Tormey DC, Gray R, Falkson HC: Postchemotherapy adjuvant tamoxifen therapy beyond five years in patients with lymph node-positive breast cancer.J Natl Cancer Inst 88:1828–1833, 1996.PubMedGoogle Scholar
  46. 46).
    Hayes DF, Van Zyl JA, Hacking A,et al: Randomized comparison of tamoxifen and two separate doses of toremifene in postmenopausal patients with metastatic breast cancer.J Clin Oncol 13:2556–2566, 1995.PubMedGoogle Scholar
  47. 47).
    Pyrhonen S, Valavaara R, Modig H,et al: Comparison of toremifene and tamoxifen in postmenopausal patients with advanced breast cancer; A randomized double-blind, the ‘nordic’ phase III study.Br J Cancer 76:270–277, 1997.PubMedGoogle Scholar
  48. 48).
    Pyrhonen S, Valavaara R, Vuorinen J,et al: High dose toremifene in advanced breast cancer resistant to or relapsed during tamoxifen treatment.Breast Cancer Res Treat 29:223–228, 1994.PubMedGoogle Scholar
  49. 49).
    Henderson MD, Buroker TR, Samson MK,et al: Response of patients with carcinoma of the breast to hormonal therapy and combination chemotherapy.Surg Gynecol Obstet 141:232–234, 1975.PubMedGoogle Scholar
  50. 50).
    Westerberg H: Tamoxifen and fluoxymesterone in advanced breast cancer; A controlled clinical trial.Cancer Treat Rep 64:117–121, 1980.PubMedGoogle Scholar
  51. 51).
    Kellokumpu-Lehtinen P, Houvinen R, Johansson R: Hormonal treatment of advanced breast cancer; A randomized trial of tamoxifen versus nandrolone decanoate.Cancer 60:2376–2381, 1987.PubMedGoogle Scholar
  52. 52).
    Santen RJ, Lipton A, Kendall J: Successful medical adrenalectomy with amino-glutethimide.JAMA 230:1661–1665, 1974.PubMedGoogle Scholar
  53. 53).
    Harris AL: Endocrine studies and clinical response in premenopausal aminoglutethimide treated breast cancer patients. In: Paesi FJA ed, Aminoglutethimide (Orimeten); Mechanism of Action and Clinical Results in Breast Cancer, Ciba-Geigy, Basle, ppl56–162, 1982.Google Scholar
  54. 54).
    Santen RJ: Biochemical effects of aminoglutethimide in premenopausal women; Clinical and biochemical effects in prostatic carcinoma. In: Paesi FJA ed, Aminoglutethimide (Orimeten); Mechanism of Action and Clinical Results in Breast Cancer, Ciba-Geigy, Basle, ppl46–162, 1982.Google Scholar
  55. 55).
    Bhatnager AS, Hausier A, Schieweck K,et al: Estrogen depletion in advanced breast cancer; Why, how and where are we going. In: Rubens RD ed, Advanced Breast Cancer; Reassessing hormonal therapy, The Parthenon Publishing Group, New York, pp21–30, 1996.Google Scholar
  56. 56).
    Falkson G, Dombernowsky P, Smith I,et al: Double blind randomized phase Ilb/III trial of two doses of letrozole and megestrol acetate as second line treatment for patients with breast cancer.Ann Oncol 7:19, 1996.Google Scholar
  57. 57).
    Marty M: Letrozole and aminoglutethimie compared in postmenopausal women with advanced breast cancer. In: Mouridsen HT ed, New Options for the Therapy of Advanced Breast Cancer, The Parthenon Publishing Group, New York, pp21–25, 1997.Google Scholar
  58. 58).
    Ravdin PM, Fritz NF, Tormey DC,et al: Endocrine status of pre-menopausal node-positive breast cancer patients following adjuvant chemotherapy and long-term tamoxifen.Cancer Res 48:1026–1029, 1988.PubMedGoogle Scholar
  59. 59).
    Manni A, Arafah B, Pearson OH: Changes in endocrine status following anti-oestrogen administration to premenopausal and post-menopausal women. In: Sutherland RL ed, Non-steroidal Anti-oestrogens Molecular Pharmacology and Anti-tumour Activity, Academic Press, New York, pp435–450, 1981.Google Scholar
  60. 60).
    Cash R, Brough AJ, Cohen MNP,et al: Aminoglutethimide (Elipten-Ciba) as an inhibitor of adrenal steroidogenesis; Mechanism of action and therapeutic trial.J Clin Endocr 27:1239–1248, 1967.PubMedGoogle Scholar
  61. 61).
    Graves PE, Salhanick HA: Stereoselective inhibition of aromatase by anantimers of amninoglutethimide.Endocrinology 105:52–57, 1979.PubMedGoogle Scholar
  62. 62).
    Sedlacek SM, Horwitz KB: The role of progestins and progesterone receptors in the treatment of breast cancer.Steroids 44:467–484, 1984.PubMedGoogle Scholar
  63. 63).
    Mouridsen HT, Ellemann K, Mattson W,et al: Therapeutic effect of tamoxifen versus tamoxifen combined with medroxyprogesterone acetate in advanced breast cancer in post-menopausal women.Cancer Treat Rep 63:171–175, 1979.PubMedGoogle Scholar
  64. 64).
    Forastiere AA, Braun TJ, Wittes RE,et al: Sequential vs. simultaneous tamoxifen (T) and megace (megesterol acetate) (M) in advanced breast cancer. Program of the Twelfth International Congress of Chemotherapy, Florence, Italy, pp 101 (Abstract 265), 1981.Google Scholar
  65. 65).
    Garcia-Giralt E, Jouve M, Palangie T,et al: Sequential administration of tamoxifen and medroxyprogesterone acetate in disseminated breast cancer; Results of a controlled trial.Proc Am Soc Clin Oncol 3:129, 1984.Google Scholar
  66. 66).
    Tormey DE, Lippman ME, Edwards BK,et al: Evaluation of tamoxifen doses with and without fluoxymesterone in advanced breast cancer.Am Intern Med 98:139–144, 1983.Google Scholar
  67. 67).
    Ingle JN, Twito DI, Schaid DJ,et al: Combination hormonal therapy with tamoxifen plus fluoxymesterone versus tamoxifen alone in postmenopausal women with metastatic breast cancer; An updated analysis.Cancer 67:886–891, 1991.PubMedGoogle Scholar
  68. 68).
    Ingle JN, Green SJ, Ahmann DL,et al: Randomised trial of tamoxifen alone or combined with aminoglutethimide and hydrocortisone in women with metastatic breast cancer.J Clin Oncol 4:958–964, 1986.PubMedGoogle Scholar
  69. 69).
    Smith IE, Harris AL, Morgan M,et al: Tamoxifen versus aminoglutethimide versus combined tamoxifen and aminogluthemide in the treatment of advanced breast carcinoma.Cancer Res 42 (suppl): 3430s-3433s, 1982.PubMedGoogle Scholar
  70. 70).
    Robertson JFR, Walker KJ, Nicholson RI,et al: Combined endocrine effects of LHRH agonist (Zoladex) and tamoxifen (Nolvadex) therapy in premenopausal women with breast cancer.BrJ Surg 76:1262–1265, 1989.Google Scholar
  71. 71).
    Boccardo F, Rubagotti A, Perrotta A,et al: Ovarian ablation versus goserelin with or without tamoxifen in pre-preimenopausal patients with advanced breast cancer; Results of a multicentric Italian study.Ann Oncol 5:337–342, 1994.PubMedGoogle Scholar
  72. 72).
    Jonat W, Kaufmann M, Blarney RW,et al: A randomized study to compare the effect of the luteinising hormone releasing hormone (LHRH) analogue goserelin with or without tamoxifen in pre- and perimenopausal patients with advanced breast cancer.Eur J Cancer 31A(2):137–142, 1995.PubMedGoogle Scholar
  73. 73).
    Smith IE, Harris AL, Stuart-Harris R,et al: Combination treatment with tamoxifen and aminoglutethimide in advanced breast cancer.Br Med J 286:1615–1616, 1983.Google Scholar
  74. 74).
    Wilson AJ: Response in breast cancer to a second hormonal therapy.Rev Endocrine Related Cancer 14:5–11, 1983.Google Scholar
  75. 75).
    Harvey HA, Lipton A, White DS,et al: Cross-over comparison of tamoxifen and aminoglutethimide in advanced breast cancer.Cancer Res 42(Suppl):3451s-3453s, 1982.PubMedGoogle Scholar
  76. 76).
    Rose C: When tamoxifen fails in the treatment of advanced breast cancer; Which endocrine therapy comes next? In: Mouridsen HT ed, New Options for the Therapy of Advanced Breast Cancer, The Parthenon Publishing Group, New York, pp33–41, 1997.Google Scholar
  77. 77).
    Hug V, Thames H, Clark J: Chemotherapy and hormonal therapy in combination.J Clin Oncol 6:173–177, 1988.PubMedGoogle Scholar
  78. 78).
    Noguchi M, Tajiri K, Taniya T,et al: Influence of hormones on proliferation of ER-positive cells and ER-negative cells of human breast cancer (MCF-7).Oncology 47:19–24, 1990.PubMedGoogle Scholar
  79. 79).
    Bianco AR, DePlacido S, Gallo C,et al: Adjuvant therapy with tamoxifen in operable breast cancer; 10 years results of the Naples (GUN) study.Lancet 2:1095–1099, 1988.PubMedGoogle Scholar
  80. 80).
    Fisher B, Redmond C, Brown A,et al: Adjuvant chemotherapy with and without tamoxifen in the treatment of primary breast cancer; 5-year results from the National Surgical Adjuvant Breast and Bowel Project Trial.J Clin Oncol 4:459–471, 1986.PubMedGoogle Scholar
  81. 81).
    Marshall JS, Gordon NH, Hubay CA,et al: Assessment of tamoxifen as adjuvant therapy in stage II breast cancer; A long-term follow-up.Lab Clin Med 109:300–307, 1987.Google Scholar
  82. 82).
    Blomqvist C, Tiusanen K, Elomaa I,et al: The combination of radiotherapy, adjuvant chemotherapy (cyclophosphamide-doxorubicin-ftorafur) and tamoxifen in stage II breast cancer; Long-term follow-up results of a randomised trial.BrJ Cancer 66:1171–1176, 1992.Google Scholar
  83. 83).
    Mauriac L, Durand M, Chauvergne J,et al: Adjuvant trial for stage II receptor-positive breast cancer; CMF vs. CMF + tamoxifen in a single centre.Breast Cancer Res Treat 11:179–186, 1988.PubMedGoogle Scholar
  84. 84).
    Tormey DC, Gray R, Gilchrist K,et al: Adjuvant chemohormonal therapy with cyclophosphamide, methotrexate, 5-fluorouracil, and Prednisone (CMFP) or CMFP plus tamoxifen compared with CMF for premenopausal breast cancer patients; An Eastern Cooperative Oncology Group Trial.Cancer 65:200–206, 1990.PubMedGoogle Scholar
  85. 85).
    Schumacher M, Bastert G, Bojar H,et al: Randomized 2 × 2 trial evaluating hormonal treatment and the duration of chemotherapy in node-positive breast cancer patients.J Clin Oncol 12:2086–2093, 1994.PubMedGoogle Scholar
  86. 86).
    Taylor IV SG, Knuiman MW, Sleeper LA,et al: Six-year results of the eastern cooperative oncology group trial of observation versus CMFP versus CMFPT in postmeno-pausal patients with node-positive breast cancer.J Clin Oncol 7:879–889, 1989.PubMedGoogle Scholar
  87. 87).
    Hubay CA, Gordon NH, Pearson OH,et al: Eight-year follow-up of adjuvant therapy for stage II breast cancer.World J Surg 9:738–749, 1985.PubMedGoogle Scholar
  88. 88).
    Boccardo F, Rubagotti A, Bruzzi P,et al: Chemotherapy versus tamoxifen versus chemotherapy plus tamoxifen in node-positive, estrogen receptor-positive breast cancer patients: results of a multi-centric Italian study.J Clin Oncol 8:1310–1320, 1990.PubMedGoogle Scholar
  89. 89).
    Fisher B, Redmond C, Legault-Poisson S,et al: Postoperative chemotherapy and tamoxifen compared with tamoxifen alone in the treatment of positive-node breast cancer patients aged 50 years and older with tumors responsive to tamoxifen; Results from the National Surgical Adjuvant Breast and Bowel Project B-16.J Clin Oncl 8:1005–1018, 1990.Google Scholar
  90. 90).
    Goldhirsch A, Gelber RD: Adjuvant chemoendocrine therapy or endocrine therapy alone for postmenopausal patients; Ludwig studies III and IV.Recent Results Cancer Res 115:153–162, 1989.PubMedGoogle Scholar
  91. 91).
    Pearson OH, Hubay CA, Gordon NH,et al: Endocrine versus endocrine plus five-drug chemotherapy in postmenopausal women with stage II estrogen receptor-positive breast cancer.Cancer 64:1819–1823, 1989.PubMedGoogle Scholar
  92. 92).
    Abe O: The role of chemoendocrine agents in postoperative adjuvant therapy for breast cancer; Meta-analysis of the first collaborative studies of postoperative adjuvant chemoendocrine therapy for breast cancer (ACETBC).Breast Cancer 1:1–9, 1994.Google Scholar
  93. 93).
    Bilimoria M, Jordan VC: Is it time to develop an optimal endocrine therapy for premenopausal patients with axillary node positive and negative breast cancer?Sem Surg Oncol 12:339–345, 1996.Google Scholar
  94. 94).
    Kiang DT, Gay J, Goldman A,et al: A randomized trial of chemotherapy and hormonal therapy in advanced breast cancer.N Engl J Med 313:1241–1246, 1985.PubMedGoogle Scholar
  95. 95).
    Cocconi G, De Lisi V, Boni C,et al: Chemotherapy versus combination of chemotherapy and endocrine therapy in advanced breast cancer.Cancer 51:581–588, 1983.PubMedGoogle Scholar
  96. 96).
    Kardinal CG, Perry MC, Weinberg V,et al: Chemoendocrine therapy vs chemotherapy alone for advanced breast cancer in postmenopausal women; Preliminary report of a randomized study.Breast Cancer Res Treat 3:365–371, 1983.PubMedGoogle Scholar
  97. 97).
    Cavalli F, Beer M, Martz G,et al: Concurrent or sequential use of cytotoxic chemotherapy and hormone treatment in advanced breast cancer; Report of the Swiss Group for Clinical Cancer Research.Br Med J 286:5–8, 1983.Google Scholar
  98. 98).
    Australian and New Zealand Breast Cancer Trials Group: A randomized trial in postmenopausal patients with advanced breast cancer comparing endocrine and cytotoxic therapy given sequentially or in combination.J Clin Oncol 4:186–193, 1986.Google Scholar
  99. 99).
    Taylor SG, Gelman RS, Falkson G,et al: Combination chemotherapy compared to tamoxifen as initial therapy for stage IV breast cancer in elderly women.Ann Int Med 104:455–461, 1986.PubMedGoogle Scholar
  100. 100).
    Lippman ME: Efforts to combine endocrine and chemotherapy in the management of breast cancer; Do two and two equal three?Breast Cancer Res Treat 3:117–127, 1983.PubMedGoogle Scholar
  101. 101).
    Lippman ME, Cassidy J, Wesley M,et al: A randomized attempt to increase the efficacy of cytotoxic chemotherapy in metastatic breast cancer by hormonal synchronization.J Clin Oncol 2:28–36, 1984.PubMedGoogle Scholar
  102. 102).
    Conte PF, Pronzato P, Rubagotti A,et al: Conventional versus cytokinetic polychemotherapy with estrogenic re cruitment in metastatic breast cancer; Results of a randomized cooperative trial.J Clin Oncol 5:339–347, 1987.PubMedGoogle Scholar
  103. 103).
    Lipton A, Santen RJ, Harvey HA,et al: A randomized trial of aminoglutethimide ± estrogen before chemotherapy in advanced breast cancer.Am J Clin Oncol 10:65–70, 1987.PubMedGoogle Scholar
  104. 104).
    Carter AC, Sedransk N, Kelley RM,et al: Diethylstilbestrol; Recommended dosage for different categories of breast cancer patients; Report of the Cooperative Breast Cancer Group.JAMA 237:2079–2085, 1997.Google Scholar

Copyright information

© The Japanese Breast Cancer Society 1998

Authors and Affiliations

  • Masakuni Noguchi
    • 1
    • 2
  • Koichi Miwa
    • 2
  1. 1.Operation CenterKanazawa University Hospital, School of Medicine, Kanazawa UniversityKanazawa 920Japan
  2. 2.Department of Surgery (II)Kanazawa University Hospital, School of Medicine, Kanazawa UniversityJapan

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