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The Roll of Castration in Breast Cancer

Arch Surg. 1964;88(5):743-746. doi:10.1001/archsurg.1964.01310230019005.
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For more than 65 years, castration has been employed in the management of breast carcinoma in premenopausal women because of the beneficial effect following deprivation of the ovarian estrogenic hormone. Castration performed at the time of or immediately following the initial definitive treatment of the primary breast tumor has been referred to as "prophylactic" castration. When carried out at the time the cancer recurs following the initial primary tumor therapy, it is termed a "therapeutic" castration. Recent reviews describe the proponents for each of these approaches to castration.1,2

Those in favor of prophylactic castration contend that this is superior to no castration and demonstrate a delay in the onset of recurrence after mastectomy and an increased survival time. It has been claimed that prophylactic castration increases the cure rate of patients in whom radical mastectomy is performed for cancer confined to the breast or regional lymph nodes. Others strongly


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