Adrenalectomy for control of cancer of the breast

Bilateral oophorectomy and adrenalectomy were used in the treatment of ten patients with advanced metastatic carcinoma of the breast, and particular attention was given to preoperative and postoperative management by a team of specialists including surgeons, endocrinologist, radiologist and pathologist. Objective and gratifying clinical remissions were achieved in three of the ten patients in this series following total oophorectomy and adrenalectomy. The remaining seven patients all subsequently died of metastatic disease. There were no operative deaths. Known cerebral or hepatic metastasis contraindicates adrenalectomy for metastatic cancer of the breast. Five of the seven patients not benefited by the operation had either cerebral or hepatic metastasis. The best candidates for adrenalectomy are premenopausal women who have previously had a clinical remission following oophorectomy and who have subsequently relapsed. The indications for adrenalectomy in the postmenopausal woman are not clear.