A Little History Lesson

I know we have all heard statistics about breast cancer but has anyone ever heard the history of it? How about the advances in science since it was first diagnosed? Well, I thought maybe we could all use a little history lesson.

Okay, first of all, what is breast cancer exactly? Breast cancer is a cancer that starts in the breast, usually in the inner lining of the milk ducts or lobules. There are different types of breast cancer, with different stages, aggressiveness and genetic makeup

Breast cancer could be one of the oldest known forms of cancerous tumors in humans. The oldest description of cancer was discovered in Egypt and dates back to approximately 1600 B.C. 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."

For centuries, physicians described similar cases in their practices, with the same conclusion. It wasn't until doctors achieved a greater understanding of the circulatory system in the 17th century that they could establish a link between breast cancer and the lymph nodes in the armpit. In the 18th century, a wide variety of medical explanations were proposed, including physical injuries to the breast, curdled breast milk and various forms of lymphatic blockages, either internal or due to restrictive clothing. 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.

The French surgeon, Jean Louis Petit and later the Scottish surgeon Benjamin Bell were the first to remove the lymph nodes, breast tissue and underlying chest muscle. Their work was carried on by William Stewart Halsted who started performing mastectomies in 1882. On a side note, Jean Louis Petit was the inventor of the tourniquet and Benjamin Bell was an early advocate of routine pain relief in surgery (thank you Benjamin!).

William Halsted

Back to William Halsted...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. By the way, Halsted was addicted to cocaine and morphine throughout his professional career (yikes!). Radical mastectomies remained the norm until the 1970's, when a new understanding of metastasis led to perceiving cancer as a systemic illness AND a localized one and more sparing procedures were developed. This means that the cancer can be found either in the breast only and it also could have spread throughout the system.

Mammogram

Mammography and chemotherapy were introduced in the 20th century. Research confirmed a hereditary component of breast cancer. Breast cancer was recognized as a major health problem in the Western world, stimulating a concerted effort against it. With the addition of chemotherapy, treatment of breast cancer truly became a coordinated effort of specialists, bringing to bear a medley of surgery, radiation therapy, and systemic chemo-hormonal
therapy on the local and systemic components of the disease.

For the record, in the United States in 2004 an estimated 217,000 women continued to develop breast cancer each year and 40,000 died of it annually. With screening and modern therapy, the death rate had begun to decline and overall relative survival 5 years after diagnosis, cured and uncured, was 86.6%. In 2010, about 425,000 women around the world died of breast cancer. In the last three decades, the number of new breast cancer cases more than doubled around the world.

I hope you enjoyed this little history lesson. I did the best I could and had to leave out a lot! There are numerous websites that can give you a lot more history if you are interested. After reading this, I hope you understand the importance of finding a cure and fighting this fight.