To the Editor.—I am responding to the article by Brown et al, entitled "Bilateral Adrenalectomy for Metastatic Breast Carcinoma" (Arch Surg 110:77-81, 1975). Several of their findings were in agreement with our published results, as listed below:
Sulfokinase activity in breast cancer tissue is not a good predictive index for adrenalectomy.1 Since our preliminary report, more than 56 patients have been evaluated; results were not encouraging.
In evaluating 119 patients who had undergone adrenalectomy in our institution, we did not find any correlation of a tumor-free interval to subsequent response to adrenalectomy. Forty percent of the patients with tumor-free intervals of less than one year had responded to adrenalectomy, compared with 47% to 48% of patients with longer tumor-free intervals.1 However, other clinical criteria, such as age, menopausal status, and cytohormonal evaluation, are of minor importance in relationship to subsequent clinical response to adrenalectomy.