A history of breast cancer

Breast cancer is an ancient disease and has been mentioned in almost all periods of history. Doctors have always pointed out that breast cancer is visible, although the untrained eye, a small group of large tumors. Unlike other fatal diseases (heart disease, and most other types of cancer), breast cancer, it was announced in a tangible way (Leopold, 1999). But despite the visibility of the disease has had breast cancer and strong reverberation, especially for women and society in general has been a discussion of breast cancer only in medical journals in 1970 found. Historically, the chest, with its many cultural expectations of women, especially their sexual and care obligations. Perhaps because my mother is such a cultural power that the disease was considered by many as a taboo subject and many of his patients are often embarrassed about the disease openly. Earlier this gap in the literature outside of medical journals is in sharp contrast with the presence of the disease is highly visible in contemporary culture. Today is not a public forum, it is common in breast cancer (Leopold, 1999). Given the success of breast cancer activism in 1990, the symbol of breast cancer – pink ribbon – is omnipresent in American culture and politics, and health officials are recognizing the role that political and cultural factors in the search for a cure.

Ancient Egypt and Greece: breast cancer as a systemic disease

The ancient Egyptians were the first to observe the disease more than 3,500 years. Both George Edwin Smith and Ebers papyri contain descriptions of conditions that are consistent with the description of modern breast cancer. For example, depicts an anonymous former Egyptian surgeon “bulging tumors” in the chest and says “there is no cure.” In 460 BC, Hippocrates, the father of Western medicine, breast cancer, a disease described as moody. In other words, by Hippocrates, the body composed of four “humors” (blood, phlegm, yellow bile and black bile), which reflects the basic elements of nature (air, fire, earth and water) – and an imbalance in the system moods to cause death or illness. For cancer of Hippocrates was “melonchole. The excess of black bile, or the causes of this logic makes sense, Hippocrates, due to the emergence of untreated breast cancer would be dark and difficult, eventually erupting on the skin with the black liquid. Karkinos called cancer, have a Greek word meaning “cat”, because the tumor appeared tentacles, like the legs of a crab. Hippocrates as a dangerous operation because he had the tumor removed go “quickly, while those that do not intersect over time (Olsen, 2002) lived.

In 200 AD, Galen, Hippocrates ‘successors’, including cancer described as exaggerated “black bile”, but, unlike Hippocrates, Galen also recognized that some tumors are more dangerous than others. Galen also describes a wide range of pharmaceutical agents for breast cancer, such as opium, castor oil, licorice treatment, sulfur, and a variety of ointments and incantations to the gods. For humoral medicine, surgery to remove the tumor or the whole breast was not even an option for a cure, since the cancer only in the vicinity of the surgical site or anything else made in the body. possibility of Galen and their physicians for the next 2,000 years, breast cancer is a systemic disease, it was a disease of the whole body, not just a localized part seriously. black bile thought naturally throughout the body – for example, when a tumor was removed, bile is retained in the body, willing to pay more for produce tumors.

Until the seventeenth century, a medical condition that Galen had the last word on breast cancer and that there is nothing to find out more. But in 1680, started the French physician Francois de la Boe Silvio humors theory of cancer with the argument that the cancer does not lead to an excess of black bile, but a chemical process called the lifeblood of strong acid challenge. In 1730, Paris-Claude Gendron doctor Deshais also rejected the theory of humors, and insisted that cancer develops when nerves and glandular tissue of the lymphatic vessels (Olson 1999) mixed.

18th century: breast cancer as a localized disease and major surgery

In 1769, the humoral theory had lost much of its importance. To rebut the humoral theory, the French physician Jean Astruc was a piece of breast tissue, with a slice of beef, and burned them in an oven and is chewed. Both have the same taste, and closed the tumor tissue did not contain abnormal amounts of bile or acid. disproved the theory of humors, doctors began a new source of cancer research, and many have argued that their origin was sexual. 1713, Bernardino Ramazzini, the doctors knew it was hypothesized that the high frequency of breast cancer in sisters of the lack of sex after Ramazzini, without a regular sexual activity, reproductive organs, including breast cancer and began to disintegrate was the result. Friedrich Hoffmann set of Prussia, that women who had sex regularly, but still developed cancer exercised Sex “with force” can lead to lymphatic obstruction.

But there were other, non-sexual theories presented. Giovanni Morgagni blamed sour milk. Johannes de Gorter in 1750, claimed that the wine tumors pus-filled sores on the chest, which sent mixed with blood in the mammary gland and dried in a tumor. Claude-Nicolas Le Cat Rouen said that depression causes cancer by a narrowing of blood vessels and the capture of coagulated blood. Lorenz Heister put women without children at high risk, while others blame a sedentary lifestyle, decreases body fluids. Although there are theories, the cause of breast cancer remains a mystery, it was as if the old man. But unlike the old, the eighteenth century, doctors slowly and ensure that breast cancer is a localized disease. This had enormous consequences, because in contrast to the humoral theories that treatment mastectomy bypass of the systemic nature of the tumors were considered, physicians increasingly skeptical about everything, but surgery (Olson 1999).

In 1757 Henri Le Dran has claimed, a leading French physician, that surgery may effectively cure breast cancer, if infected axillary lymph nodes were removed. Similarly, said Claude-Nicolas Le Cat, the knife was the only way to treat cancer. The cat to amputate the breast, lymph nodes and cut the pectoralis major. These doctors were convinced that the presence of a tumor, not necessarily a big problem, but it was a disease of a site that can be surgically removed at the local level prior to release. This theory lasted until the twentieth century and led to the creation of radical mastectomy (Hellman, 1993).

William Halstead radical mastectomy and the paradigm

In the mid-nineteenth century, most doctors believed that cancer was caused by a localized disease, surgery was the only hope. The development of antiseptics, anesthesia, blood transfusions and Cell Biology – made possible radical surgery – as well as increased public confidence in the medical field. Gone are the days of pre-anesthesia, the speed and skill required of a patient often resistant. Surgeons now have time to deliberate precision and William Halstead of New York radical breast surgery, the gold standard for the next 100 years. Halstead was the recurrence of the disease that is often experienced by patients within a year after his first surgery, and also help reduce the most advanced patient-inflicted. While the initial breast surgery, axillary lymph nodes, and pectoral M. I, who was not sufficient to Halstead. He knew that cancer is a disease of cells and are worried about their role in the spread of it. He argued that raising the spread of breast surgeon removed his hands, probably the tumor cells. This has led to a radical mastectomy: removal of the breast, called the axillary lymph nodes and chest muscles in a single unit process. He cut off around the tumor, the removal of any tissue in one piece.

During the first four decades of the twentieth century, dominated by radical mastectomy to treat breast cancer. Halstead were hundreds of radical mastectomy and asked that women be added to a radical mastectomy before the cancer has spread to regional lymph nodes to receive. While life can be extended radical mastectomy for something and the pain was reduced sick sinus has not been a blessing. Some women avoid surgery because it would hurt and disfigured for the rest of their lives. Women have had to deal with a deformed chest wall, hollow under the collarbone and armpit, chronic pain, and lymphedema or swelling of the arm due to lymph nodes under the arm was removed without liquid cycle longer working efficiently. Halstead dismissing these effects as a necessary evil, it was also the average age of women is “almost 55 years [and] has ceased to be active members of society” (Olson 1999).

Halstead also led to reflect on the amputation of the shoulder. For Halstead and his followers, cutting away the tissue was always the only way to treat breast cancer. Jerome Urban, the architect of the super-radical mastectomy in 1949, to remove the breast, axillary nodes, pectoral muscles and internal mammary lymph nodes in a single process, often in patients the tumors were smaller than a centimeter in diameter.

20th Century surgery: ovariectomy, adrenalectomy and hypophysectomy

In 1895, Scottish surgeon George Beatson discovered that the removal of the ovaries was reduced in a patient with breast cancer her. This news spread and soon the surgeons to perform “prophylactic” oophorectomy involves removal of both ovaries and implementation of a radical mastectomy. The operations are debilitating and unpredictable results, because the surgeons had no way of determining which tumors have estrogen receptors. For this reason, in 1920, most surgeons oophorectomy used only as a last resort. What is modern oncologists now know that some breast tumors have estrogen receptors that are different from estrogen. The removal of the ovaries, in some cases, the tumor is dying of hunger, at least temporarily. The tumor grows again and again into the body through the secretion of substances similar to estrogen in the adrenal and pituitary glands recovered. In 1952, almost simultaneously with radical mastectomy super-urban, Charles Huggins began removing women’s adrenal gland (adrenalectomy) in an effort to deprive tumors of estrogen. Rolf Herbert Olivecrona Lefft hypophysectomies and has started to implement, or the removal of the pituitary gland. The side effects were visual disturbances, personality changes and cognitive difficulties. Even with these extreme operations that kill tumors or backward.