Hormonal Pathogenesis of Adenocarcinoma of the Breast

When speaking of the mystery which surrounds the origin of cancer, the discussion obviously cannot be limited to a simple etiological point of view. It must be known whether or not the production of a malignant tumor is due to the intervention of an element of external origin, or, on the contrary, to a cellular dysfunction of internal origin. Whether cancer represents primarily a parasitic or a cellular disease, the basic problem consists in finding the mechanism whereby an agent, either of exogenous or endogenous origin, provokes this definite cytological change in cellular division which characterizes malignant growth. One comes always, in the final analysis, to a cytological problem. In spite of innumerable investigations, it has not yet been possible to establish the existence of a strictly specific characteristic of a cancerous cell, either by way of morphology, immunology, chemistry or physiology, other than a loss of subordination to the rhythm of division. This essential characteristic, in itself, permits the cancer process to be defined as the illimitable power of multiplication in the organism, which is acquired by one cell and transmitted to its descendants. In this sense it would be a type of mutation, in the nature of an irreversible cytological change. In fact, at the present time it is not possible, by any form of therapy, to reestablish cellular order, and the cure of cancer can be obtained only by the total extirpation of all the neoplastic elements or by their destruction in situ.