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Hypophysectomy in metastatic breast cancer
Archives of Surgery (Chicago, Ill. : 1960)
|March 1, 1975
Summary
Extracranial transethmoidal-sphenoidal hypophysectomy achieved objective remission in 58% of women with metastatic breast cancer. Remission was highest for osseous metastases and those with prior hormonal therapy response.
Area of Science:
- Oncology
- Neurosurgery
- Endocrinology
Background:
- Metastatic breast carcinoma poses significant treatment challenges.
- Hormonal therapies are a cornerstone in managing advanced breast cancer.
- Pituitary surgery offers a potential avenue for managing hormone-dependent metastases.
Purpose of the Study:
- To evaluate the efficacy of extracranial transethmoidal-sphenoidal hypophysectomy in treating metastatic breast carcinoma.
- To identify patient subgroups most likely to benefit from hypophysectomy.
Main Methods:
- A cohort of 50 women with metastatic breast carcinoma underwent hypophysectomy.
- The surgical approach involved a transethmoidal-sphenoidal route via a periorbital incision.
- Patients were followed for 12 months to assess remission and complications.
Main Results:
- Objective remission of metastases was observed in 58% of patients.
- Highest remission rates were seen in patients with osseous metastases (83%) and prior response to oophorectomy and androgen therapy (86%).
- Patients with primary CNS metastases or hepatic metastases had poor outcomes; non-responders to prior hormonal therapy did not achieve remission.
Conclusions:
- Extracranial hypophysectomy is an effective treatment for select patients with metastatic breast carcinoma.
- Patient selection based on metastatic site and response to prior hormonal therapy is crucial for successful outcomes.
- The transethmoidal-sphenoidal approach is feasible, with manageable complications such as transient diabetes insipidus and extraocular palsies.