Is aminoglutethimide an alternative to adrenalectomy for metastatic carcinoma of the breast?

Aminoglutethimide inhibits steroid synthesis by the adrenal gland and the peripheral conversion of androgens to estrogens. As such it has been recommended in the place of adrenalectomy for the treatment of advanced breast cancer. Aminoglutethimide with hydrocortisone was given to 19 women with metastatic cancer of the breast whose disease was progressive, who would otherwise have undergone adrenalectomy and whose potential for response was good. Four patients could not tolerate the drug and seven failed to respond. Eight women had an objective response, complete in two and partial in four. In two patients the disease stabilized. The period of treatment ranged from 11 to 26 months but three patients are still on treatment after 26 months. The authors conclude that aminoglutethimide has a place in the management of women with advanced breast cancer who satisfy the criteria for hormone manipulation.