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A natural, or biologic, division of patients with disseminated mammary carcinoma into responsive and non-responsive groups, on the basis of the results of palliative therapy with sex steroids, was apparent in evidence published in these pages earlier this year. The same self-selected, inherent disparity of effectiveness is evident when the endocrinologic milieu of the patient is altered by more heroic techniques, i.e., ablation of adrenal glands or of the hypophysis. Significant, although preliminary, data on these surgical attacks are presented in this issue, p. 787, by a Joint Committee representing the American College of Physicians and the American College of Surgeons, designated to undertake a retrospective study of pooled information from 14 teaching centers, selected because of a known interest in one or the other operation. After a preliminary analysis of samples formed by 404 bilateral adrenalectomies and 466 hypophysectomies, the committee recommended publication of a report emphasizing certain findings
PREDETERMINISM IN PALLIATION OF BREAST CANCER. JAMA. 1961;175(9):800-801. doi:10.1001/jama.1961.03040090060015