In 1896, Bit Johnson (Beatson) for the first time two cases of pre-menopausal advanced breast cancer patients undergoing oophorectomy, after see the cancer receded, and achieved good results. This is caused by the medical profession at that time a great shock. After 10 years in the United Kingdom made a total of more than 100 cases of the above-mentioned operation, of which about 1 / 3 of patients get a good effect. It was invented in 1905 to remove radiation to treat breast cancer, ovarian function.
Which in the end the patient is suitable for line in ovariectomized treated? Current research shows that mainly depends on breast cancer are hormone-dependent or non-hormone-dependent, and only patients with estrogen-dependent breast cancer would only be appropriate in the line of ovarian castration, the latter category are not necessarily effective. Generally clinical breast cancer axillary lymph node metastasis or peacetime to menstrual pain more pronounced when the breasts, and as a hormone-dependent patients could be considered the treatment of ovarian castration. In other words, if a patient’s tumor estrogen receptor-positive, especially with extensive axillary lymph node metastasis or subclavian lymph nodes metastasis, suitable for making androgen deprivation therapy. Pre-menopausal and post-menopausal string of less than five years who, if breast cancer recurrence after resection, but unsuitable for radiotherapy patients, especially in estrogen receptor-positive can also be considered for ovarian androgen deprivation therapy. Right ovariectomy in patients after a period of time tumor shrinkage, symptom relief, but the effects will not last forever. Factors that affect the efficacy of ovarian castration are:
(1) Age: pre-menopausal or post-menopausal patients with less than 1 year the efficacy of a good line in ovariectomized; menopause a year or more are often ineffective or rarely effective. Menopause before the age of 46 to 50 have the highest efficiency, with an average of up to 37% ~ 40%; while the age of 35 years of age only 22% of the patients effectively.
(2) Menstruation: The normal menstrual laws of those who have higher efficiency, about 34.5%; do not rule by 27%.
(3) Since the operation to the recurrence interval of time: the interval between surgery to recurrence longer have the higher the efficiency. Less than 1 year were, effectively, 28%; 2 to 4 years were 34%; 5 years more than 55%.
(4) relapse site: confined to the breast, supraclavicular lymph nodes, soft-organizer, with high efficiency, 40%; bone, pleura, lungs metastasis in 26%; liver and peritoneal metastasis, 8.6%; brain metastasis is invalid.
(5) estrogen receptors, progesterone receptors: estrogen receptor (ER)-positive rate was 60% ~ 70%; negative rarely effective. ER and progesterone receptor were positive up to 80% efficient.
Susceptible patients after ovariectomy cardiovascular disease, serum cholesterol, triglycerides were higher as compared with castration. For post-menopausal patients who had been for many years, may have atrophy and loss of ovarian function, androgen deprivation therapy has been meaningless. For a smaller range of local recurrence and distant metastasis of patients, radiotherapy is still the first choice, pending further transfer, and then consider doing androgen deprivation therapy. Therefore, choosing castration treatment time is very important.
