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Medical adrenalectomy in patients with advanced breast cancer
Author(s) -
Horsley J. Shelton,
Newsome Heber H.,
Brown Peter W.,
Neifeld James P.,
Terz Jose J.,
Lawrence Walter
Publication year - 1982
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19820315)49:6<1145::aid-cncr2820490614>3.0.co;2-7
Subject(s) - medicine , adrenalectomy , aminoglutethimide , discontinuation , breast cancer , bilateral adrenalectomy , surgery , dexamethasone , cancer , urology , aromatase
Medical adrenalectomy, consisting of aminoglutethimide plus either dexamethasone or hydrocortisone, was administered to 53 women with advanced breast cancer. Sixteen (30%) patients had an objective response, five patients had stabilization of disease, 26 patients demonstrated progression of disease, two patients did not adhere to protocol, and four patients had severe toxicity necessitating discontinuation of the drugs. Medical adrenalectomy accurately predicted response to subsequent surgical adrenalectomy in 23 patients. Estrogen receptor (ER) data accurately predicted response (eight of nine (89%) ER‐positive patients responded) or failure (only two of 14 (14%) ER‐negative patients responded) to medical adrenalectomy. Thirty (of 51 women adhering to protocol) had no toxicity. Therefore, it appears that medical adrenalectomy is safe, usually well tolerated, and can accurately predict response to surgical adrenalectomy. Its use should be limited to ER‐positive patients, and it may totally supplant surgical adrenalectomy in the management of advanced breast cancer.