OOPHORECTOMY AND CORTISONE TREATMENT AS A METHOD OF ELIMINATING OESTROGEN PRODUCTION IN PATIENTS WITH BREAST CANCER

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Abstract
The urinary excretion of oestrone, oestradiol-17β, oestriol, and 17-hydroxycorticosteroids has been estimated in 55 premenopausal and 91 postmenopausal women with breast cancer at various stages of the disease before therapy. The depletion of oestrogen excretion caused by oophorectomy combined with cortisone treatment was studied in the patients with metastasising breast tumours (32 premenopausal and 56 postmenopausal subjects). Patients with disseminating breast cancer excreted significantly larger quantities of oestriol than healthy women of the same age, whether preor postmenopausal. The excretion of oestrone and oestradiol-17β was similar in cancer patients and healthy women of corresponding age. Oophorectomy reduced the oestrogen excretion not only in premenopausal subjects but also in quite a number of postmenopausal patients, particularly in those who were still excreting significant amounts of oestrogens. This decrease in the oestrogen output was transient and was followed by a compensatory increase, possibly of adrenal origin. Cortisone administered within a month after the oophorectomy at a dosage of 50 mg per day rapidly depressed the secondary rise in the oestrogen output to a level of about 4 to 5 μg/24 h irrespective of the age of the patient. This excretion level was unchanged as long as cortisone was given in an adequate dose, but increased rapidly when the cortisone treatment was discontinued. Oophorectomy combined with adequate cortisone treatment seems to offer an alternative to the extensive surgical procedures undertaken to eliminate oestrogen production in breast cancer patients.