Metastatic breast cancer in males. Assessment of endocrine therapy

From June 1958 to June 1982, 22 men with metastatic breast cancer were treated with endocrine therapy. All 22 patients were initially treated by bilateral orchiectomy, and objective response was seen in 11 (50%) patients for 15 months. Bilateral adrenalectomy was performed subsequently in 10 patients, and 8 (80%) patients had a mean duration of objective response of 15 months. Five of seven orchiectomy responders and 3 of 3 orchiectomy nonresponders subsequently responded to bilateral adrenalectomy. Tamoxifen was tried in three patients after relapse following adrenalectomy; all three patients responded with a mean duration of 9 months. One patient was successfully treated with aminoglutethimide for 7 months following orchiectomy failure. In this patient bilateral adrenalectomy was performed on disease relapse and again resulted in objective remission. In this review, a sequential endocrine therapy program provided palliation in men. Further study is required to determine the timing of the various endocrine modalities.