Adrenalectomy for advanced breast cancer: a reappraisal.
The introduction of strict criteria of treatment response for advanced breast cancer facilitates comparison of treatment modalities. Recent studies of pharmacological measures are usually recorded according to UICC criteria but this has not been the case with regard to adrenalectomy. An analysis of 41 patients undergoing adrenalectomy for advanced breast cancer was undertaken to assess response according to UICC criteria. There were no complete objective responses but 12.2% had Partial Remission and 12.2% Static Disease, the remainder showing disease progression. These figures are lower than in most reported series which have used less clearly defined criteria of response. The Partial Response and No Change groups were similar in terms of symptomatic improvement and survival but superior to the treatment failure group. Adrenalectomy was associated with significant morbidity (46.7%) and operative mortality (6.7%). Only 1 patient of 11 previously treated with tamoxifen had a subsequent response to adrenalectomy. The low response rate when assessed on UICC criteria and high morbidity when compared with alternative treatment suggest that adrenalectomy will be less widely used in the future.
D000315:Adrenalectomy; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009362:Neoplasm Metastasis; D010166:Palliative Care