The Changing Role of Castration in Breast Cancer Patients
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All who are involved with the care of young women with breast cancer must be aware that it is now 100 years since George Beatson (1896) when only 47 years of age, dared to remove the ovaries of a 33-year-old Glasgow woman with progressing recurrent disease. A rapid and convincing remission occurred but, despite reporting this in the Lancet a year later, it was not until the 1930s that real interest in ovarian ablation developed. A few earlier reports had confirmed the effectiveness of the procedure but it was when Taylor (1934) first suggested the possibility of benefit from removing the ovaries at the time of mastectomy that interest seemed to increase. For the next 30 years the results of many small retrospective series were published with indirect comparisons of outcome from early (prophylactic or adjuvant) with that from late (post-relapse or “therapeutic”) ovarian ablation. Conflicting conclusions were drawn but the balance of opinion was in favour of the therapeutic approach, largely because of the dramatic and sometimes prolonged responses which could occur. It was argued that early ablation would be unnecessary in 40% and that the tumour would be unresponsive in 75% of the remainder leaving only 15% to benefit from prophylactic therapy.
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- Blarney RW, Jonat W, Kaufmann M et al (1992) Goserelin depot in the treatment of premenopausal advanced breast cancer. Eur J Cancer 28A: 810–814Google Scholar
- Boyle TJ, O’Boyle CJ, McNamara A, Geoghegan I, Given HF (1995) Laparascopic Oophorectomy: an adjuvant therapy in primary premenopausal breast cancer (Abstr). Scientia 3: 6Google Scholar
- Cole MP (1975) A clinical trial of an artificial menopause in carcinoma of the breast. Horm Breast Cancer INSERM 55: 143–150Google Scholar
- Early Breast Cancer Trialists’ Collaborative Group (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy: 133 randomised trials involving 31000 recurrences and 24000 deaths among 75000 women. Part 1. Lancet 339: 1–15Google Scholar
- International Breast Cancer Study Group (1990) Late effects of adjuvant oophorectomy and chemotherapy upon premenopausal breast cancer patients. Ann Oncol 1: 30–35Google Scholar
- Meakin JW, Allt WEC, Beale FA et al (1977) Ovarian irradiation and prednisone following surgery for carcinoma of the breast. In: Salmon SE, Jones SE (eds) Adjuvant therapy of cancer. Elsevier/North-Holland, Amsterdam, pp 95–99Google Scholar
- Nemoto T (1973) Treatment of early breast cancer: survey of surgeons. NY State J Med 1901–1904Google Scholar
- Scottish Cancer Trials Breast Group (1993) and ICRF Breast Unit, Guy’s Hospital, London: Adjuvant ovarian ablation versus CMF chemotherapy in premenopausal women with pathological stage II breast carcinoma: the Scottish trial. Lancet 341: 1293–1298Google Scholar
- Stewart HJ (1970) Oophorectomy response as an index to further endocrine ablation. In: Joslin CAF, Gleave EN (eds) The clinical management of advanced breast cancer. Alpha Omega, Cardiff, pp 12–20Google Scholar