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Hormonal treatment
of Breast Cancer
Moderator: Dr. S C Sharma
HOD, Department of
Radiotherapy, PGIMER
Background
\ue000Henri Fran\u00e7ois Le Dran (1685\u20131770) gave the hypothesis
that breast cancer spread was in ao rderly fashion. The
concept was carried to it\u2019s logical conclusion by Halsted.
\ue000The Halstedian theory was based upon:
\ue001Local and regional nodes were the first echelon of
metastatic spread
\ue001They were effective barriers against further spread.
\ue000The concept was challenged by the Fisher brothers (Edward
and Bernard), who showed in a series of trials conducted by
the NSABP that:
\ue001Lymph nodes were not effective as barriers against systemic
spread
\ue001Hematogenous dissemination was as important as lymphatic
dissemination
\ue000Systemic therapy is therefore believed to beeffecti ve in
this disease.
History
\ue000Schinzinger was the first person to propose that
oophorectomy might be of benefit in breast
cancer:
\ue001Post menopausal breast atrophy
\ue001More virulent tumor growth in premenopausal
\ue000The first reported series of surgical oophorectomy
for breast cancer was reported by Thomas
Beatson (1896)

\ue001Showed significant tumor regression by castration
\ue001Better sense of well being
\ue001Regression of cutaneous metastasis
\ue001Best above age of 40
\ue001No effect on osseous metastatsis

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