Breast cancer, surgical resection 1. Resection of adrenal and pituitary purpose is to remove the source of estrogen in the body, or has been mainly used to remove the ovaries of postmenopausal women. Adrenalectomy on liver and brain metastases often per effect, while the bone, lung, soft tissue and pleural metastasis is better. Recurrence interval from surgery to cure more than 2 years or more efficient in terms of constant dollars is less than 2 years were effective. Adrenalectomy in postmenopausal women, the body can eliminate plexiform layer secreted by the adrenal cortex and pregnant ene two intoxicated intoxicated to estrogen conversion. Cortisone after adrenalectomy to be added daily 50_70mg, adrenal gland removed an average of 32% efficiency. Effective use of previous oophorectomy or hormone receptor positive, efficient and up to 50% _60%. After the effective lifetime of the cases was significantly longer than the void, the average is about 1_2 years. In recent years, application of drug aminoglutethimide (amino derivative can sleep) can play the role of drug adrenalectomy, bilateral adrenalectomy has been so rarely used.
2. Pituitary removal efficiency averaged 34%, and hormone receptor-positive cases up to 60% efficiency, while more than 10 years of menopause better efficacy. The liver, brain, lung lymphatic metastasis often ineffective, while the soft tissue, lymph nodes, stomach and pleural metastasis is better. Pituitary resection, removed the pituitary secretion of prolactin and growth hormone, human chorionic gonadotropin also removed ACTH, thereby reducing ovarian estrogen and corpus luteum from the same level, after leaving lower ACTH ACTH in glucocorticoid hormones, the synthesis of estrogen and progesterone decrease to be added after adrenocorticotropic hormone, thyroid hormone and factors such as vascular decompression. Pituitary resection, there are two common ways that the amount of ways and by transsphenoidal approach, similar effect in two ways. General application after adrenalectomy for pituitary do not have to cut, and vice versa.
Breast cancer, surgical resection 3. Bilateral oophorectomy used in the treatment of advanced breast cancer before menopause, can shrink the tumor, the reason is complete or after ovariectomy is not completely eliminate the effect of estrogen on the tumor, the method of ovariectomized with surgery or radiation method, the difference is that the occurrence of radiation therapy effects from treatment often takes a long time, and faster in the role of surgery. For selected patients without the application of the effective rate of oophorectomy 30% _40%, while the hormone receptor-positive cases efficiency up to 50% _60%. And effective case can also get a longer postoperative survival, clinical factors can affect the efficacy of oophorectomy in premenopausal or postmenopausal patients 1 year of good effect, and menopausal age of 1 year or more, or less than 35 years of age poorer treatment outcomes; surgery and recurrence interval for a long time, especially more than 2 years or more is expected to get a good effect, for the liver and brain metastases often ineffective, and soft tissue, lymph nodes, lungs, and bone metastasis good effect. For preventive ovariectomy is controversial, and now mainly used in prophylactic ovary removal before menopause, high risk of lymph node recurrence wider, and determination of hormone receptor-positive, postmenopausal patients are not suitable for young or preventive ovariectomy.