Major endocrine ablation therapy was carried out in 133 patients with advanced breast cancer. Of 40 patients undergoing left suprarenal to inferior mesenteric venous shunt with bilateral oophorectomy and right adrenalectomy, 16 cases (40 per cent) had an objective response. The mean postoperative survival of the patients with a positive response, those showing some response and those who failed to respond was 35-8, 26-5 and 8-8 months respectively. Thus, the results of the present procedure are comparable to those of adrenalectomy. No replacement therapy with corticoids was necessary. An increase in the response rate and extension of the survival time can be expected with the addition of postoperative long term maintenance therapy with chemotherapeutic agents and androgens.