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Urinary three estrogens (estrone, estradiol-17 [3 and estriol) in patients with advanced breast cancer before and after oophorectomy and adrenalectomy were chemically determined in an attempt to evaluate response of cancer to the surgery and its subsequent relapse. Results are as follows: 1. The existence of adrenal estrogens was evidenced indirectly in control subjects. 2. The high levels of preoperative urinary estrogens. probably due to the adrenal gland, were observed more frequently in aged patients with advanced breast cancer than in aged normal women. Most of ·the patients who had shown urinary hyperestrogenism in the basal and reserved estrogen levels obtained remission by the surgery. 3. The levels of postoperative persistent urinary estrogens in patients with advanced breast cancer lowered during the withdrawal of maintenance corticoids, and did not rise after the administration of ACTH and/or gonadotrophin. Any significant difference between the postoperative urinary estrogen levels in remission and relapse groups was not demonstrated. It may be therefore suggested that postoperative urinary estrogens are mainly derived from maintenance corticoids, and that cancer relapse after initi11l response to oophorectomy and adrenalectomy is not due to the re-increase of urinary estrogens based on the functioning of the accessory adrenocortical tissue.

STUDIES ON URINARY ESTROGENS IN PATIENTS WITH ADVANCED BREAST CANCER IN REFERENCE TO OOPHORECTOMY AND ADRENALECTOMY.