A brief history of surgical treatment of breast cancer

The surgical treatment of breast cancer has a history of more than 2,000 years from the 1st century AD to the present. I thought that to understand a disease, we must first understand the history of human understanding, diagnosis, and treatment. Only in this way can we be far-sighted, whether it is necessary for researchers, medical survivors, or patients. Overall, the surgical treatment of breast cancer has gone through five stages: original partial resection, radical surgery, enlarged radical surgery, improved radical surgery, breast preservation, and axillary preservation surgery. 

At present, due to the advancement of diagnostic technology and the improvement of people's awareness of breast cancer, the early diagnosis rate has been continuously increasing, and improved radical surgery and breast preservation surgery have become common surgical styles, especially breast preservation surgery, which considers both the therapeutic effect and the aesthetics and may become the mainstream surgical style in the future.

Original partial resection

From 460 BC to 377 BC, the ancient Greek doctor Hippocrates described breast cancer, unveiling the history of human understanding of breast cancer. The surgical treatment of breast cancer began in the 1st century AD. The Greek doctor Leonides first discovered that breast cancer patients had nipple depressions, and first performed breast mass resection, and some scholars performed a total mastectomy. In that era, surgery was performed without anesthesia, and hemostasis was only performed with fire branding, which was very primitive.

In the 10th-16th century AD, it was recognized that breast cancer could not be cured by removing tumors or breasts alone. Cabrol first began extensive local resection, including the pectoral muscles and some surrounding normal tissues; later, many doctors found that the axillary lymph nodes of breast cancer patients were enlarged. Severinus was first carried out for the removal of breast cancer at the same time, the enlarged axillary lymph nodes were removed.

However, before the 19th century, it was believed that breast cancer was a local lesion, and treatment focused only on the local area. Due to the lack of good anesthesia, hemostasis, and anti-infective drugs, the operation was cruel, the mortality rate was extremely high, and the short-term recurrence rate reached more than 90%. Doctors also began to suspect that breast cancer was not a localized disease, but due to the limitations of medical conditions at the time, there was no breakthrough in treatment.

Stage of radical breast cancer treatment

In the 19th century, with the development of anatomy and the application of microscopy in pathology, basic medicine made great strides, and the law of lymphatic metastasis of breast cancer gradually been recognized. In 1822, Elliott first used a microscope to discover the infiltration of tumor cells in the axillary lymph nodes. In 1846, Morton in the United States used ether for general anesthesia. Since then, the development of anesthesiology has solved the problem of surgical pain control, and the surgeon can operate calmly. In 1852, Joseph Pancoast of the United States was the first surgeon to propose a whole breast and axillary lymph node resection. For the first time, a joint incision of the breast and armpit was used to perform the whole breast.

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