Massive estrogen administration in premenopausal women with metastatic breast cancer

Abstract

HE ROLE of hormonal therapy in advanced T breast cancer has been well established.Castration is of beneficial value in premenopausal women.Occasionally a few years after spontaneous cessation of the menses, when there is evidence of residual ovarian activity by vaginal smear, castration has also produced objective regression of metastatic cancer.Administration o estrogenic hormones works favorably against advanced breast cancer in postmenopausal women, and the use of this hormone is limited to this older age group.l.9 Small physiological amounts of estrogenic hormone administered to premenopausal women may stimulate the growth of existing breast cancer, and its administration to women who previously responded to therapeutic castration may result in reactivation of the breast cancer.I2T h e apparent therapeutic dichotomy between the withdrawal of estrogenic hormone by castration in the premenopausal woman and the administration of estrogenic hormone in the postmenopausal woman has been without a satisfactory explanation.In 1940, Zondekl3 attempted to inhibit the growth of breast cancer in a 26-year-old woman by administering 10 mg. of estradiol benzoate.T h e rationale for his investigation was the observation that large doses of estrogenic hormone experimentally produced dwarfing by inhibiting growth hormone from the anterior pituitary gland and that estrogens inhibited gonadotropic hormone.