A Brief History of Breast Cancer : Part I: Surgical domination reinvented

Abstract

The female breast has always been a symbol of beauty, fertility and femininity. In disease, however, it has challenged physicians since antiquity. Surgery, which ruled the roost for cancer therapy, inevitably caused disfigurement when the knife was applied to the breast. The history of breast cancer is a complex maze of attempts to understand the wily nature of this hormone-responsive cancer and the will of physicians to conquer it by physical removal (surgery), cell destruction (chemo-radiotherapy) or targeted therapy to cell receptors (biomodulation). It is also a saga of intense exploration to find the tools to enable early diagnosis. The story of the domination of surgery over two millennia and its evolution from fatalistic choices to minimal damage is told in the succeeding paragraphs. The pathobiological basis of breast cancer that changed chirurgical practice from crudity to finesse is woven through the narrative.