To the Editor: Despite the high prevalence of recurrent disease in patients with locally-advanced carcinoma of the breast, little increase in survival has been afforded these persons since the original work of Halsted and Meyer. In an attempt to improve survival, surgeons have added endocrine manipulation to their therapeutic armamentarium — oophoroadrenalectomy and hypophysectomy with adjunctive androgens, estrogens, and cytotoxic drugs. With these methods of empirical hormonal manipulation, objective remissions range from 31 to 58 per cent at best, with the only predictive indicator of response being the patient's menopausal status. The disparity between expected and observed results of endocrine., No extract is available for articles shorter than 400 words. © 1974, Massachusetts Medical Society. All rights reserved.