Early ("prophylactic") oophorectomy and adrenalectomy in carcinoma of the breast: a ten-year follow-up.

Early "prophylactic" oophorectomy and adrenalectomy has been performed on 12 patients with carcinoma of the breast. The patients selected were considered to have a very bad prognosis on account of axillary node involvement associated with internal mammary chain deposits (9 patients), supraclavicular nodes (2 patients) and a parasternal mass (1 patient). Five patients had evidence of spread beyond the primary lymph drainage area (axillary and internal mammary nodes), and all had died within 4 years. In 7 patients the disease was confined to the primary lymph drainage area and 4 lived for more than 10 years, 3 being alive and well at 11 to 12 years. This is a higher proportion than in a control series but does not quite reach the level of statistical significance. In the 7 patients with disease confined to the axillary and internal mammary nodes prognosis was not apparently related to malignancy determined histologically, but did have an association with the extent of invasion of the axillary nodes. Urinary oestrogen estimations performed in 4 patients did not give any evidence that outcome was related to persistence of oestrogen production. Details of the patients' management and replacement therapy are given and from prolonged personal follow-up of these patients it is concluded that women who have undergone oophorectomy and adrenalectomy are able to lead full and active lives.