[Hypophysectomy in metastasing carcinoma of the breast (author's transl)]

As result of a poll, the opinion of 50 Neurosurgical Departments in the Federal Republic of Germany relating to the importance of hypophysectomy in the therapy of metastatic carcinoma of the breast was obtained. Four of 32 replies prefer a regular hypophysectomy and 11 departments do the hypophysectomy only in exceptional cases. In 17 clinics this operation is not used. It should be emphasized, that a quarter of those neurosurgeons, who took part in our inquiry, had already given up hypophysectomy some years ago. About 50% of the surgeons talk about positive effects on metastatic carcinomas. The hormonal dependence of disseminated cancers is the only condition, which has to be presumed. Implantation of radioisotopes and trans-sphenoidal hypophysectomy are mentioned as the main operative techniques. The indications for hypophysectomy for metastatic carcinoma of the breast are discussed in the light of the recent literature. If one considers the possibilities of radiotherapy and chemotherapy, hypophysectomy can still be of considerable value as a palliative measure in hormone-dependent tumours with bone metastases, provided that the cases are carefully selected.