Could aminoglutethimide replace adrenalectomy?

Could aminoglutethimide replace adrenalectomy? This question has already been answered in clinical practice in the United Kingdom, for surgical adrenalectomy has declined markedly in frequency as new hormonal therapy has appeared. An optimal assessment of an endocrine therapy can only be made in previously untreated patients because of the heterogeneity of previously treated populations. Thus aminoglutethimide (AG) and adrenalectomy have been compared for previously untreated and treated populations. Because AG is commonly called 'medical adrenalectomy', this article will review and compare aminoglutethimide therapy with surgical adrenalectomy and make the case that surgical adrenalectomy is no longer indicated in the management of breast cancer.