Medical and surgical adrenalectomy in patients with advanced breast carcinoma.

Twenty-four postmenopausal patients with metastatic breast carcinoma were placed on aminoglutethimide and dexamethasone as a form of reversible medical adrenalectomy. Six patients experienced adverse side-effects. Of the 18 remaining patients 50% had a definite subjective or objective response to therapy. Thirteen of these patients underwent subsequent surgical adrenalectomy after a maximum of 3 month's trial of the medical regimen. In every patient the response to therapy was identical with the two modalities of therapy. In those postmenopausal patients with metastatic breast cancer who are felt to have a hormone- dependent tumor by clinical and/or hormonal assay criteria, medical adrenalectomy may eventually be a feasible replacement for surgery in selected cases. As important, perhaps, is the potential value of this medical adrenalectomy as a reliable indicator of the subsequent response to endocrine ablative therapy.