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INTRODUCTION: Endocrine treatment of breast cancer is undoubtedly a valuable therapeutic manoeuvre, but the success of this treatment is only partial. First, less than half of patients will show an objective response to treatment and second, those who do respond to treatment, other than in the adjuvant context, eventually relapse. Thus over half show intrinsic (or de novo) resistance and the others develop acquired resistance. An understanding of the mechanisms by which this resistance occurs should provide alternative approaches to improve effectiveness.

It is axiomatic that such an understanding can only occur when the mechanism(s) of response itself is known. It is equally necessary that an understanding of tumour response requires a prior knowledge of the determinants of tumour growth, the antagonism or deprivation of which result in tumour regression. Although there is strong evidence for certain basic components of the requirements for tumour growth and regression only a moderate