REVIEW   

Chirurgia 2019 June;32(3):133-6

DOI: 10.23736/S0394-9508.18.04830-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Historical review of breast cancer surgery

Damir GREBIĆ ¹ ✉, Matea HRBOKA ², Daniel V. ŠIMAC ³, Nevija ŽEPINA ¹

¹ Department of General and Oncological Surgery, Faculty of Medicine, Rijeka Clinical Hospital Center, University of Rijeka, Rijeka, Croatia; ² Integrated Undergraduate and Graduate Medical Program, Faculty of Medicine, University of Rijeka, Rijeka, Croatia; ³ Department of Hematology, Rheumatology and Clinical Immunology, Rijeka Clinical Hospital Center, Rijeka, Croatia

Breast cancer is the most common malignant tumour in women worldwide. It is said that one in eight women will develop breast cancer. Morbidity and mortality increases with age, significantly after the age of 45, with peak morbidity in the 50s. Breast cancer is known to be one of the earliest described malignancies in medicine. The first description of the disease and its treatment are found in the Edwin Smith Papyrus. Hippocrates, a Greek physician, considered the father of medicine, also differentiated ulcerative breast cancers, and noticed that the disease manifested on the skin, and resembled “crab legs”, hence the name cancer. The development of surgery stagnated during the Middle Ages, with a resurgence during the Renaissance and significant progression. Radical breast removal was advocated. Fabricius Acquapendente is credited with introducing informed consent for surgery for woman, which is a necessary and important document in medicine even today. Halsted introduced the radical mastectomy, which persisted as the surgery of choice for over a century, until it was proven that removing the chest muscles and third axilla did not have any affect on prognosis. The modified radical mastectomy was subsequently introduced which continues to be the approach for breast surgery to present day. Initial treatments advocated highly aggressive surgical techniques, believed to be necessary to ensure survival. Such attitudes have changed in the direction of conserving surgery for breast as well as for the axilla.

KEY WORDS: Breast neoplasms - Mastectomy - Surgery - History