History of Breast Cancer

The history of breast cancer spans thousands of years, and the understanding and treatment of the disease have evolved significantly…

By Staff , in History of Disorders , at September 11, 2024 Tags: health, medicine

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The history of breast cancer spans thousands of years, and the understanding and treatment of the disease have evolved significantly over time. From early descriptions in ancient texts to modern advances in diagnosis and therapy, breast cancer has long been a major focus of medical study and innovation. Here is an overview of the history of breast cancer:

Ancient History (3000 BCE – 500 CE)
Ancient Egypt:
The earliest known descriptions of breast cancer are found in ancient Egyptian medical texts, particularly the Edwin Smith Papyrus, which dates to around 3000-2500 BCE. In this text, there is a description of tumors or ulcers of the breast, which are said to be untreatable.
The ancient Egyptian physicians recommended cauterization, or burning, as the only way to deal with such growths. It was noted that there was no known cure for breast cancer, suggesting that even the ancient Egyptians recognized the severity of the disease.

Ancient Greece:
The Greek physician Hippocrates (460-370 BCE), often called the “Father of Medicine,” described breast cancer as a “humoral disease.” According to Hippocrates, an imbalance of the four bodily humors (blood, phlegm, yellow bile, and black bile) caused illness. He associated cancer with an excess of black bile, which led to the concept of cancer as a systemic disease, deeply ingrained in early medical thought.
Another influential Greek physician, Galen (129-216 CE), expanded on this theory in the Roman Empire. He described breast cancer as a hard tumor that arose from an excess of black bile. Galen also noted that breast cancer was more common in postmenopausal women.

Middle Ages and Renaissance (500-1600 CE)
During the Middle Ages, knowledge of cancer and its treatment stagnated. Medical practice was heavily influenced by religious beliefs and the humoral theory, which continued to dominate. Surgery was rare, and most treatments involved herbal remedies, purging, or cauterization.

In the Renaissance period (14th to 17th century), medical knowledge began to improve, particularly with the advent of dissection and advances in anatomy. However, breast cancer remained poorly understood, and treatments were still primitive.

18th and 19th Centuries: Surgery and Early Understanding
Rise of Surgery:
In the 18th century, advances in surgical techniques marked a turning point in breast cancer treatment. Henri François Le Dran, a French surgeon in the mid-18th century, proposed that breast cancer originated in the breast and could spread to the lymph nodes. He advocated for surgical removal of both the tumor and affected lymph nodes.
By the late 19th century, more radical surgical techniques were being developed. The most significant figure in this movement was American surgeon William Stewart Halsted, who pioneered the radical mastectomy in the 1880s. This procedure involved the removal of the entire breast, the underlying chest muscle, and the lymph nodes in the armpit. Halsted’s radical mastectomy became the standard treatment for breast cancer for many decades.

Pathology and Classification:
The 19th century also saw advancements in the study of cancer pathology. German pathologist Rudolf Virchow developed the idea that cancer arose from abnormal cells, marking a departure from the humoral theory. This cellular theory of cancer began to shape the way scientists and doctors thought about the disease.
Jean Astruc, a French physician in the 18th century, was one of the first to describe different types of breast cancer, distinguishing between hard and soft tumors.
20th Century: Early Detection, Radiation, and Chemotherapy

Mammography and Early Detection:
One of the most significant developments in the fight against breast cancer came in the mid-20th century with the development of mammography. The first mammograms were performed in the 1910s, but it wasn’t until the 1960s that the technology was refined enough to be used as a regular screening tool for breast cancer. Mammography allowed for earlier detection of tumors, often before they were palpable, improving the chances of successful treatment.

Radiation Therapy:
Radiation therapy emerged as a treatment for breast cancer in the early 20th century. In the 1920s, Marie Curie’s discoveries in radioactivity laid the groundwork for radiation treatment. It was used to target cancerous cells in the breast and became a common part of breast cancer therapy, especially in conjunction with surgery.

Chemotherapy:
In the mid-20th century, chemotherapy began to be used as a systemic treatment for breast cancer. The first chemotherapy agents, derived from mustard gas, were introduced in the 1940s and 1950s. Over the following decades, chemotherapy drugs like cyclophosphamide, methotrexate, and fluorouracil were developed and used to treat breast cancer, particularly in more advanced stages or when the cancer had spread beyond the breast.
In the 1970s and 1980s, adjuvant chemotherapy (chemotherapy given after surgery to prevent cancer recurrence) became a standard practice in breast cancer treatment.

Hormonal Therapy:
In the 20th century, it was discovered that hormones, particularly estrogen, played a role in the growth of some breast cancers. British surgeon George Beatson showed in 1896 that removing the ovaries could shrink breast tumors, highlighting the link between hormones and breast cancer.
In the 1970s, the drug tamoxifen was developed as a treatment for estrogen receptor-positive (ER-positive) breast cancer. Tamoxifen blocks estrogen receptors, reducing the growth of tumors that depend on estrogen. It became one of the most widely used treatments for hormone-sensitive breast cancer.
Late 20th Century to Present: Targeted Therapy and Advances in Treatment

Targeted Therapy:
The late 20th century and early 21st century have seen the development of targeted therapies, which are drugs that specifically target the molecular mechanisms driving cancer growth. One of the most important breakthroughs came in 1998 with the approval of trastuzumab (Herceptin), a drug that targets the HER2 protein, which is overexpressed in some breast cancers. Herceptin has dramatically improved outcomes for women with HER2-positive breast cancer.

Genetic Understanding:
In the 1990s, researchers discovered that mutations in the BRCA1 and BRCA2 genes significantly increased the risk of developing breast and ovarian cancer. This led to the development of genetic testing for women with a family history of breast cancer. Women found to carry BRCA mutations can undergo increased surveillance or preventive measures such as prophylactic mastectomy (preventive removal of the breasts).
The identification of these mutations also spurred research into personalized medicine, where breast cancer treatment is tailored to the individual’s genetic profile.

Breast-Conserving Surgery:
While the radical mastectomy dominated treatment for much of the 20th century, it was eventually replaced by less invasive techniques. In the 1970s and 1980s, lumpectomy (removal of the tumor and a small margin of surrounding tissue) followed by radiation therapy became a standard alternative for early-stage breast cancer. This breast-conserving surgery allowed women to avoid the more disfiguring radical mastectomy while achieving similar outcomes in terms of cancer control.

Immunotherapy:
Recent developments in immunotherapy have shown promise in treating some forms of breast cancer. Immunotherapy works by stimulating the body’s immune system to recognize and attack cancer cells. While immunotherapy is still a developing field for breast cancer, it holds potential for the future of treatment.

Breast Cancer Awareness and Advocacy:
In the late 20th century, breast cancer became a focus of global public health efforts. Organizations such as the Susan G. Komen Foundation and the Breast Cancer Research Foundation have been instrumental in raising awareness and funding research. The pink ribbon campaign, which began in the 1990s, has become a symbol of breast cancer awareness worldwide.