[Hormone therapy of breast cancer in the metastatic phase in menopausal women].

Hormone therapy for breast cancer was initially used before menopause due to the castration effect but rapidly was extended to menopaused women. Over the last 20 years, two major types of hormone therapy have been developed, those based on surgical removal of the adrenal or pituitary glands and medical treatment with estrogens and androgens. There are currently 3 major classes of medical hormone therapies. Antiestrogens can provide objective remission in about one-third of the patients. These drugs block the estrogen receptors. Progestins can also be effective in about 40% of the patients. The third class currently includes two aromatase inhibitors, aminoglutethimide and 4 OH androstenedione. These drugs block estrogen and estradiol secretion in the ovaries and adrenal glands. Combination therapies have also been used in an attempt to take advantage of the different mechanisms of action. Others have added chemotherapy, attempting to optimize the chronology of these two complementary treatments. In case of relapse after an initial treatment, second line hormonotherapy can again be used, with objective response varying from 32 to 46% in patients who had responded to the initial treatment.