CA: A Cancer Journal for Clinicians, Vol 11, 48-54, Copyright
© 1961 by American Cancer Society
The Rationale of Endocrine Therapy in Breast Cancer
Milton Dworin M.D.1
1 Clinical Instructor of Medicine, Cancer Teaching Service, and Medical Consultant, New York University, New York, N. Y.
Thomas Beatson, the Glasgow surgeon, wrote in 1910: "One of the values attached to oophorectomy [now also true for hormonal and other ablative measures] is that the effects produced seem to me to have their chief interest and importance in that they throw a light upon the nature of carcinoma as a disease."
We are still profoundly ignorant of the real nature of hormone dependence in cancers arising in organs which are themselves hormone-dependent, but it probably is safe to assume in the case of hormone dependent breast cancer that the hormones essential for progressive proliferation of the cells of this tumor are those produced under physiological conditions for normal mammogenesis. It may be that these physiological hormones are produced by the cancer patient in excessive quantities, or in unphysiological proportions. It may even be that the normal mammogenic hormones are changed or modified by the breast cancer patient, but there is liter ally no evidence either to support or to disprove these purely hypothetical conceptions.
It is abundantly clear, however, that the intelligent investigation of hormone dependence in cancer, as well as its rational treatment by endocrine ablation, must be based upon our knowledge of breast physiology and especially of the complex interplay of those hormones which control the proliferation by mitosis of normal mammary epithelium.
