Breast cancer historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Jack Khouri, Mirdula Sharma, MBBS [2]

Overview

Breast cancer may be one of the oldest known forms of cancer tumors in humans.

Historical Perspective

Discovery

  • The oldest evidence of breast cancer was discovered in Egypt and dates back to approximately 1600 BC.[1]
  • The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization. The writing says about the disease, "There is no treatment."[2]
  • The ancient medicine, from the times of the Greeks through the 17th century, was based on humoralism, and thus believed that breast cancer was generally caused by imbalances in the fundamental fluids that controlled the body, especially an excess of black bile.[3] Alternatively, patients often saw it as divine punishment.[4]
  • In the 18th century, a wide variety of medical explanations were proposed, including a lack of sexual activity, too much sexual activity, physical injuries to the breast, curdled breast milk, and various forms of lymphatic blockages, either internal or due to restrictive clothing.[3][5]
  • In the 19th century, the Scottish surgeon John Rodman said that fear of cancer caused cancer, and that this anxiety, learned by example from the mother, accounted for breast cancer's tendency to run in families.[5]
  • Although breast cancer was known in ancient times, it was uncommon until the 19th century, when improvements in sanitation and control of deadly infectious diseases resulted in dramatic increases in lifespan. Previously, most women had died too young to have developed breast cancer.[5]

Landmark Events in the Development of Treatment Strategies

  • Mastectomy for breast cancer was performed at least as early as AD 548, when it was proposed by the court physician Aetios of Amida to Theodora.[3]
  • It was not until doctors achieved greater understanding of the circulatory system in the 17th century that they could link breast cancer's spread to the lymph nodes in the armpit.
  • The French surgeon Jean Louis Petit (1674–1750) and later the Scottish surgeon Benjamin Bell (1749–1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle.[6]
  • Their successful work was carried on by William Stewart Halsted who started performing radical mastectomies in 1882. William Stewart Halsted was helped greatly by advances in general surgical technology, such as aseptic technique and anesthesia. The Halsted radical mastectomy often involved removing both breasts, associated lymph nodes, and the underlying chest muscles. This often led to long-term pain and disability, but was seen as necessary in order to prevent the cancer from recurring.[7] Before the advent of the Halsted radical mastectomy, 20-year survival rates were only 10%; Halsted's surgery raised that rate to 50%.[8] Extending Halsted's work, Jerome Urban promoted superradical mastectomies, taking even more tissue, until 1963, when the ten-year survival rates proved equal to the less-damaging radical mastectomy.[7]
  • Breast cancer staging systems were developed in the 1920s and 1930s.[7]
  • The first case-controlled study on breast cancer epidemiology was done by Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health.[9]
  • Radical mastectomies remained the standard of care in America until the 1970s, but in Europe, however, breast-sparing procedures, often following radiation therapy, were generally adopted in the 1950s.[7]
  • Radical mastectomies remained the standard of care in America until the 1970s.
  • During the 1970s, a new understanding of metastasis led many to perceive cancer as a systemic illness, as well as a localized one; more sparing procedures were developed that proved equally effective. Modern chemotherapy developed after World War II.[10]
  • In the 1980s and 1990s, thousands of women who had successfully completed standard treatment demanded and received high-dose bone marrow transplants, thinking this would lead to better long-term survival. However, it proved completely ineffective; 15–20% of women died because of the brutal treatment.[11]
  • The 1995 reports from the Nurses' Health Study and the 2002 conclusions of the Women's Health Initiative trial conclusively proved that hormone replacement therapy significantly increased the incidence of breast cancer.[11]

Cultural References

  • In the month of October, breast cancer is recognized by survivors, family, friends of survivors, and/or victims of the disease. A pink ribbon is worn to recognize the struggle that sufferers face when battling the cancer.
  • Pink for October is an initiative started by Matthew Oliphant, who asks that any sites willing to help make people aware of breast cancer change their template or layout to include the color pink, so that when visitors view the site, they see that the majority of the site is pink. Then, after reading a short amount of information about breast cancer, or being redirected to another site, they are aware of the disease itself.

References

  1. "Oldest evidence of breast cancer found in Egyptian skeleton". Reuters. 24 March 2015. Retrieved 25 March 2015.
  2. "The History of Cancer". American Cancer Society. 2002-03-25. Retrieved 2006-10-09.
  3. 3.0 3.1 3.2 Olson 2002, pp. 32–33
  4. Yalom, Marilyn (1997). A history of the breast. New York: Alfred A. Knopf. p. 234. ISBN 0-679-43459-3.
  5. 5.0 5.1 5.2 Aronowitz, Robert A. (2007). Unnatural history: breast cancer and American society. Cambridge, UK: Cambridge University Press. pp. 22–24. ISBN 0-521-82249-1.
  6. "History of Breast Cancer". Random History. 27 February 2008. Retrieved 8 May 2010.
  7. 7.0 7.1 7.2 7.3 Olson 2002, pp. 102–6
  8. Olson 2002, p. 1
  9. Alfredo Morabia (2004). A History of Epidemiologic Methods and Concepts. Boston: Birkhauser. pp. 301–302. ISBN 3-7643-6818-7. Retrieved 2007-12-31.
  10. Marc Lacroix (2011). A Concise History of Breast Cancer. USA: Nova Science Publishers. pp. 59–68. ISBN 978-1-61122-305-7.
  11. 11.0 11.1 Sulik, Gayle A. (2010). Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health. USA: Oxford University Press. pp. 200–3. ISBN 0-19-974045-3. OCLC 535493589.

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