Ultimately, the majority of patients with breast cancer will develop disseminated disease. Unlike most cancers which are autonomous in their growth pattern, some breast cancers are hormonedependent. Maneuvers which are designed to alter the hormonal milieu in a sequential fashion in time are part of our armamentarium to combat the advanced stages. The vexing problem is the selection of the optimum method or hormone for the specific patient against a background of the normal aging process which is altering her hormonal status. The choice of the various modalities and the time of administration are also philosophical since treatment can be both preventive and therapeutic.
The measure of success in hormonal therapy depends on objective criteria rather than on subjective benefits. Objective regression for hormonal or chemotherapeutic treatment is always defined as partial rather than complete regression. By standards employed in surgery and radiotherapy, such responses will be considered failures. The
Rubin P. Carcinoma of the Breast Stage IV—DisseminatedIntroduction: The Containment of Metastases. JAMA. 1967;200(11):970. doi:10.1001/jama.1967.03120240098015