Four men (mean age 50 [42-57] years) were treated for advanced carcinoma of the breast, two of them by chemotherapy alone. Survival time in the latter two after start of the chemotherapy was 5 and 8 months, respectively. The third patient received both hormone and chemotherapy from the start because of unfavourable prognostic criteria. For 15 months the tumour stage remained unchanged until the patient developed incomplete paraplegia which improved greatly after decompression laminectomy. This has been followed for four months by renewed hormonal and chemotherapy. The fourth patient received tamoxifen for seven months, with intrapleural administration of cytostatic agents and finally pleurectomy for recurrent malignant pleural effusions. For 4 months he has again been receiving hormonal and chemotherapy. These cases illustrate that if there are unfavourable prognostic criteria chemotherapy should be added to conventional hormone therapy.
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