[Hormone therapy in breast cancer]

Hormonotherapy, the oldest known effective medical treatment for breast cancer, is still widely used today. The effectiveness of numerous hormone (anti-oestrogen) treatments for breast cancer, with tumour regression reaching about 30% of the advanced forms or more in hormono-dependent forms identified by tumour hormone receptor assays has been demonstrated. Castration by surgery, radiotherapy or anti-LHRH agents is still proposed as one of the possible suppressive treatments. The other type of hormone management currently used is the anti-oestrogen agent tamoxifen which is general well tolerated. High doses of synthetic progesterones or anti-aromatase agents such as aminoglutethimide are also prescribed. These treatments require a less well tolerated association with hydrocortisone or corticosteroid treatments. Indications for hormonotherapy have become quite precise. As an adjuvant, castration before menopause and tamoxifen after menopause have been shown to be important methods in a meta-analysis published in 1992. The role of each of these treatments as part of an overall chemotherapy management is yet to be determined. In cases with metastases, hormonotherapy, whatever the modality used, is still particularly useful in elderly women with positive hormone receptor assays.