HISTORICAL OVERVIEW

Historically, treatment for breast cancer can be traced to 2000 bc. Manuscripts describing the various methods used are documented in books on surgical history. The methods in use ranged from cautery and arsenic compounds to extirpation of the breast.

In early Roman times, Aulus Cornelius Celsius was among the first to speak against the use of caustic medicines. He performed extensive surgery for breast cancer, including removal of the pectoralis muscle.

The first realistic treatment concept for breast cancer can be traced to the eighteenth and nineteenth centuries when Jean Louis Petit in France and Charles Moore in England emphasized the importance of clear margins and conceived “in block” excision of the lesion and the axillary nodes.

In 1882, in the United States, William S. Halsted reported his technique of radical mastectomy for resectable breast cancers. The technique included wide excision of the skin, resection of the pectoralis major muscle, and a complete axillary dissection. Using the new technique, he was able to reduce the local recurrence rate to 6%. In 1884, also in the United States, Willie Meyer reported a different technique for the radical mastectomy. The technical difference was in the timing of the axillary dissection. Meyer dissected the axilla before excising the breast and both pectoralis muscles.