Abstract
Sixty-four patients have undergone bilateral adrenalectomy for metastatic mammary cancer at Barnes Hospital and Ellis Fischel State Cancer Hospital with 33% demonstrating an objective response of 6 months or longer. Eleven postoperative deaths occurred and were attributed largely to advanced pulmonary metastases. Adrenalectomy was most successful in patients with metastases limited to soft tissue or bone, who had had an interval free of apparent disease, lasting 24 months or more, between radical mastectomy and tumor recurrence. Those patients having inoperable primary disease responded as well to adrenalectomy as the overall group. A previous response of the tumor to either androgen therapy or oophorectomy increased the likelihood of response to adrenalectomy. Contraindications to adrenalectomy include central nervous system or hepatic metastases, advanced pleuralpulmonary metastases and a disease free interval of less than 18 months.
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