Therapeutic castration for advanced breast cancer

Abstract

The results of therapeutic castration in advanced, recurrent, and disseminated breast carcinoma in ninety-four patients treated at the Ellis Fischel State Cancer Hospital from 1940 to 1967 inclusive were reported. Parallel with the fashion in which clinical decisions were made, the factors analyzed were divided into three groups: precastration, pericastration, and postcastration. The effects on both the rate of objective response and survival were presented. An objective response which lasted over six months occurred in 20 per cent of the patients. The response rate was better in premenopausal female patients who had previous mastectomy, a longer free interval, recurrent disease limited to bone, and the presence of metastases and corpus luteum in ovarian specimens. This last finding was especially important in postmenopausal women. Patients with any recorded objective response, even shorter than six months, had a better survival curve than did those without such response. The method of castration (surgery or radiation) and previous, coincident, or subsequent hormonal therapy had no effect on response rate or survival. However, those who required secondary therapy after a long interval (more than twelve months later) and who had subsequent major ablative therapy had a much better survival rate. Results reported in the literature from other institutions and pertinent clinical references are included and discussed in the paper.