JO'O. eds. Diagnostic Molecular Pathology: A Practical Approach. Vcl. 2. Oxford:

PostmenopausalLong disease-freeintervalBone, skin, nodeAdditive hormonal treatment (Table I) became availableduring the 1950s with the commercial production of steroidhormones. Since involution ofthe embryological breast budwhich develops in all early, sexually undifferentiatedembryos3 was known to occur under the influence ofandrogens it was perhaps not surprising that androgenscould cause regression of female breast cancer. Moresurprising perhaps was the finding that oestrogens;" whichappeared to be necessary forthe maintenance and growthof breast cancer in younger women, could also bebeneficial, albeit usually in older, postmenopausal women.Other steroid hormones such as the gestagens and modifiedandrogens such as danazol are also active.The term 'changing the hormonal milieu' was coined toindicate a hypothetical alteration between growth­stimulatory and as yet (undefined) growth-inhibitoryhormonal influences.During the 1960s much effort went into attempts to definelevels of plasma hormones or oftotal hormone productionas measured by urinary excretion of sex steroids; this wasintended to provide an index of hormone responsivenessand prognosis in breast cancer." Ultimately none of thesetests achieved any real measure of success since theseinvestigations focused on patient determinants rather thanthe nature of the tumour. However, several clinical featureswere defined which provided some guidelines for hormonetreatment of breast cancer (Table