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Medical Adrenalectomy for Treatment of Metastatic Breast Carcinoma

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Abstract

Approximately one-third of unselected patients with metastatic breast carcinoma experience objective tumor regression when treated with standard surgical ablative procedures such as hypophysectomy, adrenalectomy, or ovariectomy.(1–8) By preselection of women with estrogen-receptor-positive tumors for these procedures, two thirds can be expected to respond objectively.(9) However, the appreciable morbidity and significant mortality associated with the major surgical ablative therapies, particularly in debilitated patients, has limited their use to highly selected patients with widely metastatic disease.(1, 3, 10) For these reasons, major investigative efforts have attempted to develop chemical methods to reduce hormone secretion or block hormone action as possible alternatives to surgical ablative techniques. The term usually utilized for techniques that attempt to suppress adrenal function in lieu of adrenalectomy is “medical adrenalectomy.” In a strict sense, this term can only be validly applied to regimens that produce an identical hormonal milieu to that resulting from surgical adrenalectomy. This criterion has not been fulfilled for any of the regimens developed for medical adrenalectomy; consequently, for the purposes of this review, the term “medical adrenalectomy” is applied to those therapies whose rationale is the suppression of adrenal steroidogenesis.

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  1. Department of Medicine, Division of Endocrinology, and The Specialized Cancer Center, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, Pennsylvania, 17033, USA

    Richard J. Santen & Eugeniusz Samojlik

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  1. Richard J. Santen
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  1. University of Texas Health Science Center, San Antonio, Texas, USA

    William L. McGuire M. D.

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Santen, R.J., Samojlik, E. (1979). Medical Adrenalectomy for Treatment of Metastatic Breast Carcinoma. In: McGuire, W.L. (eds) Current Topics. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-2663-0_3

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