ADRENAL ESTROGENS IN PATIENTS WITH METASTATIC BREAST CANCER1

Abstract

Significant amounts of estrone and estriol have been demonstrated in the urine of castrated patients with metastatic breast cancer by means of countercurrent distribution, paper chromato-graphy, and bioassay methods. The excretion of these estrogens by castrated patients increased strikingly upon the administration of ACTH. With one exception, castrated and adrenalectomized patients failed to excrete identifiable amounts of estrogens. These observations suggest that estrogens or their precursors are produced by the adrenal cortex and that endogenous ACTH might be involved in the control of this estrogen production. Estriol was demonstrated in the urine of one patient who had been castrated, adrenalectomized, and hypophysectomized, raising the possibility of additional sources of estrogens besides the ovaries and adrenals, such as diet and accessory ovarian or adrenal tissue. The possible pathophysiological significance of these findings in breast cancer was discussed.