Reevaluation of rebound regression in disseminated carcinoma of the breast.

Abstract

In patients with disseminated carcinoma of the breast on estrogen therapy that develop progression of their disease, sudden cessation of estrogen was found to produce tumor regression. In a study of 97 patients with breast carcinoma treated with estrogen and followed closely, 25 patients had a trial of sudden hormonal withdrawal because of progression of their disease. Of these, eight patients (32%) had tumor remission lasting from 3 to 10 months (avg. 6.9 months). Five of the eight responders had subsequent hormonal manipulation for their progressing neoplasms, and all had experienced another tumor remission. These responders were analyzed carefully, and showed a significantly longer disease-free interval, and a longer survival period as compared to nonresponders to estrogen withdrawal. This suggests that withdrawal response in patients with advanced breast carcinoma is of value for patient prognosis, like that obtained from response to bilateral oophorectomy. Because of the freedom from side effects with the sudden estrogen withdrawal, we do feel that, whenever possible, estrogen withdrawal should be tried on breast cancer patients and an adequate period of observation should be allowed before the initiation of other more hazardous or toxic forms of therapy. An illustrative case of repeated responses to estrogen and to estrogen withdrawal will be presented.