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May 1959

Adrenal-Corticoid Depression of Adrenal Estrogens in Cases of Mammary Cancer

Author Affiliations

Ann Arbor, Mich.
Department of Surgery, University of Michigan Medical School.

AMA Arch Surg. 1959;78(5):732-737. doi:10.1001/archsurg.1959.04320050064010

Introduction  The demonstration by Beatson in 1896 that castration would effect remissions in advanced breast cancer heralded the advent of ablative therapy in this disease.1 In 1951 Huggins obtained clinical remissions following bilateral adrenalectomy in the absence of ovarian function.2 Huggins' work was not a chance clinical discovery, but was a logical result of prolonged experimentation and observation of the role of the steroid hormones in neoplasia.3 At the time of Huggins' first adrenalectomy, he postulated that the method of palliation was through the elimination of endogenous estrogen production by the host.4 Since that time, the estrogen-elimination theory of postadrenalectomy remissions has been questioned,5 but no more attractive explanation has been advanced.The welcome remissions associated with adrenalectomy have encouraged some surgeons to remove empirically the adrenals of patients with far-advanced breast cancer.6 However, since over half the patients subjected to adrenalectomy receive no

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