AbstractThe adrenal glands of 58 patients undergoing adrenalectomy for advanced breast cancer were reviewed and correlated with the subsequent course of the patients' disease. Three patients had thecomatous metaplasia in the adrenal cortex, six patients had myelolipomatous changes, and 13 patients had metastatic breast cancer in their adrenal glands at the time of adrenalectomy. Neither the presence of metastases nor myelolipomatous changes were associated with a long disease‐free interval, a long period from mastectomy to adrenalectomy, or a prolonged postadrenalectomy survival The patients with metastatic breast cancer in the adrenal glands had more widespread disease than patients without adrenal metastases. The presence of breast cancer metastases in the adrenal glands at the time of adrenalectomy identifies patients further advanced in the course of their disease, but is not related prognostically to the effect of adrenalectom