Treatment Of Mammary Cancer Research Articles

THE USE OF ESTROGENS AND ANDROGENS IN ADVANCED MAMMARY CANCER

Estrogens and androgens were used clinically in 105 female patients with either primary or recurrent inoperable mammary cancer who were, with few exceptions, ambulatory when first treated. Of this group, 55 have died of cancer and all survivors have evidence of persistent disease. Hence, the results were analyzed on the basis of temporary objective and subjective changes which occurred during one to twenty-four months' observation. In addition, various laboratory studies were made and analyzed in an attempt to evaluate the clinical changes which were observed. For various reasons, 44 patients were treated for less than one month. Since data on these patients were incomplete, they were excluded from this report. REVIEW OF THE LITERATURE Both Ulrich 1 and Loeser 2 in 1939 drew attention to the possible usefulness of androgens in the treatment of mammary cancer in the human female. Farrow and Woodard 3 in 1942 observed subjective, but no

THE USE OF ESTROGENS AND ANDROGENS IN ADVANCED MAMMARY CANCER

Estrogens and androgens were used clinically in 105 female patients with either primary or recurrent inoperable mammary cancer who were, with few exceptions, ambulatory when first treated. Of this group, 55 have died of cancer and all survivors have evidence of persistent disease. Hence, the results were analyzed on the basis of temporary objective and subjective changes which occurred during one to twenty-four months' observation. In addition, various laboratory studies were made and analyzed in an attempt to evaluate the clinical changes which were observed. For various reasons, 44 patients were treated for less than one month. Since data on these patients were incomplete, they were excluded from this report. REVIEW OF THE LITERATURE Both Ulrich 1 and Loeser 2 in 1939 drew attention to the possible usefulness of androgens in the treatment of mammary cancer in the human female. Farrow and Woodard 3 in 1942 observed subjective, but no

The Menopausal Age in Women with Cancer of the Breast

The following report is presented as an addition to our gradually increasing knowledge of the evident relationship between ovarian activity and carcinoma of the breast. The conception of such an association is by no means recent and can, indeed, be divided into three periods. First, were those observations made about forty years ago by Beatson (1), Schinzinger (2), Lett (3), and others, who noted the apparent effect of oophorectomy on the clinical course of mammary cancer. This work was largely applied to inoperable cases or postoperative recurrences and, when such a surgical procedure was advocated as a part of the treatment in an operable case, it was often considered so radical that it was not accepted as a standard procedure. The idea was based upon the clinical observation that cancer of the breast ran a slower or comparatively less malignant course in women who had passed through the menopause.About the time that these results were published, the radical surgical removal of cancer of the breast, as advocated by Willy Meyer and Halsted, was becoming popular, and, as the percentage of postoperative survivals increased the secondary measure of oophorectomy seemed to be forgotten. There was some renewed interest in this connection when sterilization by means of x-ray was advised, and it was at about this time that we entered the second phase of our knowledge of this relationship. This was in 1916, when Loeb and Lathrop (4) produced the first definite experimental evidence of the influence of sex hormones on the development of cancer in mice. Theirs was more or less negative evidence: the failure of cancer of the breast to develop in females of a strain of mice of a high known cancer incidence, castrated while young or immature. They felt that there was an ovarian hormone that regulated the tissue changes leading to the development of the tumors and that there was a quantitative relation between this hormone and the tissue response. This work was subsequently corroborated by Cori (5). Nevertheless, little, if any, clinical application was made of this fact and only occasionally was an artificial menopause advocated as an accessory to the surgical treatment of mammary cancer.

R-Doses in Primary Mammary Carcinoma

The tissue-dose (Herd-dosis) which has been advised in the treatment of mammary cancer has varied from about 700 to 8,000 r/s.* The former was the Freiburg-Erlangen “carcinoma-dose,” based on the response of some patients with skin, breast, uterine, and vulvar cancer. Whether given in one or several days, or later kept up in “saturation” over two or more weeks, this 90–110 per cent E.D. aim guided the practice of most radiotherapeutic clinics for many years. The radio resistance shown by many patients, animals, and tissue cultures to this dose suggested the employment of higher intensities (e.g., Wood and Prime: “at least five erythema doses … in tissue cultures”), and by different methods these have been given to breast tissue (usually two to four E.D.) by external or combined external and interstitial radiation. The upper limit of tissue-dose advised for breast cancer has been that of Burton Lee1, who advanced the view in 1931 that “12 or 13 erythema doses” may be advisable. His erythema was a minimal or threshold erythema; and his dose approximated 8,000 r/s, and was obtained by a combined Röntgen and interstitial radium technique. The extremes that have been advised thus have a tenfold or more range: from about 700 r/s in one day to 8,000 r/s in three weeks. A survey of over three hundred cases of primary breast cancer shows some evidence for both extremes in individual cases; but the majority have responded well with doses well within the limits which have been advised.

THE TREATMENT OF MAMMARY CANCER

Medical Journal of AustraliaVolume 1, Issue 16 p. 484-486 Original Article THE TREATMENT OF MAMMARY CANCER H. M. Moran, H. M. Moran SydneySearch for more papers by this author H. M. Moran, H. M. Moran SydneySearch for more papers by this author First published: 01 April 1935 https://doi.org/10.5694/j.1326-5377.1935.tb91507.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume1, Issue16April 1935Pages 484-486 RelatedInformation

Combined Surface and Interstitial Radiation in the Treatment of Mammary Cancer

RADIATION therapy—that ever-changing, ever-progressing, and always fascinating branch of medical science—demands new recognition as a therapeutic arm of major importance in the management and treatment of cancer of the breast. This disease, since its earliest recognition, has been considered as a purely surgical problem. This viewpoint, however, is now being challenged from observers in different parts of the world. From the Continent, several well-known radiologists assure us that either x-rays or radium, applied according to their own particular method of procedure, gives results which are equal to, or better than, those reported by surgery. While the significance of this opinion has not yet been accepted openly in America, there are, nevertheless, a considerable number of individuals here who are slowly but surely forcing upon their surgical confrères a realization that both x-rays and radium are, at least, strong allies of, if not actual substitutes for, surgery in the treatment of this devastating disease. The most recent report of Hermann Wintz,2 one of the staunch supporters of radiation therapy at Erlangen, Germany, gives results in the treatment of carcinoma of the breast by x-rays alone over a period of fifteen years, and presents conclusions which demand the attention of all those interested in carcinoma of the breast. It would appear to the open-minded that Wintz has secured sufficient evidence from his work to place his results on a parity with, or even better than, those obtained in the best of surgical circles. In fact, Howard C. Taylor, Jr., who reviews3 his work, states in conclusion: “This paper is an important one on account of the large number of cases, the invariable microscopic proof of diagnosis, and the manner in which the statistics have been compiled. Wintz himself is conservative in the statement of his conclusions, although he points to the superior results obtained in Groups II and III (Steinthal) to those obtained in surgery. Nevertheless, one cannot but conclude that, can the figures of Wintz be duplicated in other clinics, the simple surgical treatment of breast cancer will have difficulty in maintaining its present position. However, such duplication has yet to be observed. “The emphasis upon the unreliability of statistics on breast cancer as compared to uterine cancer, in which the principle of reporting five-year cures on the basis of all cases observed (absolute cure rate) has been universally adopted, appears very pertinent.” So much for the x-ray side of the question. Now let us cross the Channel and observe what one of our British colleagues, Geoffrey Keynes, says on “The Radium Treatment of Carcinoma of the Breast,”4 as ably abstracted by Howard C. Taylor, Jr.5 “The problem in the treatment of carcinoma of the breast by radium is exactly the same as in the operative treatment: how completely to extirpate the cells of the primary growth and all secondary growths that may conceivably be accessible.

Twin pregnancy after temporary suppression of menstruation following Roentgen-ray treatment for mammary cancer

Twin pregnancy after temporary suppression of menstruation following Roentgen-ray treatment for mammary cancer

The Treatment of Primary Inoperable Carcinoma of the Breast by Radiation: A Report of 54 Cases from the Breast Clinic

WITHIN the past decade, radiotherapy has become definitely established as one of the useful methods in the treatment of mammary cancer. Moreover, in the primary inoperable cases, it is now regarded by the profession generally as the method of choice. Surgeons and radiologists are demanding trustworthy data upon the results of treatment of this disease. It is deplorable that premature reports are made, a few months after treatment, of brilliant results of radiotherapy in the field of mammary cancer. Such publications are misleading and tend to throw the science of radiation into disrepute. The present paper is a report of the course and results of the treatment of 54 cases of primary inoperable carcinomata of the breast, admitted to the Breast Clinic at the Memorial Hospital prior to January 1, 1921, all patients having begun their treatment 3 years or more ago. Definition The average surgical judgment of to-day places a case of mammary cancer in the inoperable group only in the presence of very advanced d...

To the Question of Post Operative Treatment of Mammary Cancer

To the Question of Post Operative Treatment of Mammary Cancer

To the Question of Post Operative Treatment of Mammary Cancer

To the Question of Post Operative Treatment of Mammary Cancer