ABSTRACT
I. INTRODUCTION The earliest report of remissions observed after surgical castration of women with inoperable breast cancer is generally attributed to Georges Beatson, who published his seminal paper in 1896. However, it was in fact Schinzinger who suggested in 1889 that ovariectomy before or at mastectomy might help to control the disease by ‘‘involuting the breast that contains malignant cells’’ (Schizinger, 1889). The first actual trial of adjuvant castration was performed in 1948 in Manchester, UK (Cole, 1975) and initiated a whole series of comparative trials of castration versus no treatment and of castration plus chemotherapy versus chemotherapy alone. Patient numbers in these trials were, however, small and conditions were highly heterogeneous. Not all patients were premenopausal; castration was achieved either surgically or by radiotherapy with a dose ranging from 450 to 2000 rads. The results of the trials, taken individually, tended to be negative and the consensus of opinion at the end of the 1970s was that castration was ineffective. The years that followed saw the active development of other treatments, such as chemotherapy and tamoxifen administration, which seemed to be more effective.
