Hippocrates, our father of modern medicine, described breast cancer as an excess of “black bile.” Hippocrates was also the first to introduce the term, karkinos, a Greek work meaning crab, from which derived the word “carcinoma.” The mindset at that period of time was that breast cancer was spread throughout the person’s body and that surgery was not a viable option. Greeks felt that if one cut off the breast and removed the tumor, the “black bile” would course through the woman’s system and regrow.
Not until the beginning of the 18th century did doctors begin to embrace surgery as a means for a cure for breast cancer. In 1882, Dr. William Halstead performed the first radical mastectomy in the United States. From 1895 to the 1970’s, 90% of women with breast cancer underwent mastectomies, making this type of surgery the gold standard for breast cancer treatment for 75 to 100 years. Despite the often severe complications, Dr. Halstead and his colleagues continued to perform the surgeries. Dr. Halstead is quoted as saying, “The side effects were necessary evil and besides the average age of the woman was nearly 55 years of age and they were no longer active members of society.” Dr. Halstead would have a difficult time using that excuse today.
In the late 1960’s Dr. Bernard Fisher first published results of breast conserving therapy, consisting of a lumpectomy followed by irradiation. His research, recognized today as ultimately ending the standard practice of the radical mastectomy, lead to increased survival rates and improved quality of life for women with breast cancer. Dr. Fisher’s research showed that breast conserving therapy was just as effective as radical mastectomies, thereby ushering in our modern era of breast cancer treatment.