ADVANCED CARCINOMA OF THE BREAST, FAILED TESTOSTERONE OR STILBOESTROL, TREATED BY PREDNISOLONE*

SUMMARY i.  A series from private practice of 31 consecutive patients having advanced carcinoma of the breast, having failed treatment with testoterone or stilboestrol was treated with prednisolone. ii.  39% (12/31) showed no objective response. 16% (5/31) showed objective improvement for from 6 to 12 months and then relapsed. 13% (4/31) continue in remission 6 months or more but less than 12 months. 32% (10/31) had objective improvement lasting more than 12 months. iii.  Of cases at risk: 90% (28/31) have survived three months. 83% (25/30) have survived six months. 60% (12/20) have survived twelve months. 20% (3/15) have survived 24 months. 14% (2/14) have survived 30 months. iv.  Prednisolone treatment and factor of age: No patient in the 30–40 age group showed response. Three-fifths of the patients (13/22) in the 40–60 age group came into remission. All the patients in the over 60 age group came into remission. v.  Prednisolone treatment and factor of histological differentiation: Most of the cases were found to be dedifferentiated carcinomas indicating that many anaplastic car cinomas are still hormone dependent. The few adenocarcinomas in the series did not appear to give different response from the undifferentiated group. vi.  Prednisolone treatment and factor of previous hormone response: 3 of 14 (21%) patients in the series who had not responded previously to Testoterone subsequently showed objective prednisolone remission. A patient failed testosterone, therefore has approximately a 20% chance of benefiting subsequently from prednisolone. 9 of 10 (90%) patients who had previously responded to testosterone and relapsed showed subsequent prednisolone remission. Such a patient having benefited and then failed testosterone has approximately 90% chance of subsequent benefit from prednisolone. All of the patients relapsing after stilboestrol response showed subsequent response to prednisolone.