A brief history of breast medicine

Hippocrates believed that treating 'hidden cancers' did more harm than good. Today we debate whether we are over-treating some screen-detected lesions. History really does repeat itself.

A review of the history of western medicine traces the efforts of physicians to cure breast cancer: from ancient potions and poultices, through centuries of brutal but swift surgery, to the supraradical mastectomy of the early twentieth century, on to conservative surgery with adjuvant therapies. Attitudes and beliefs of patients have influenced the management of breast cancer, from quiet acceptance of extreme suffering to the vocal feminist fury against 'mutilation' by male surgeons in the 1970s.

The quest for early detection and accurate diagnosis produced a variety of imaging techniques. Some of them, thankfully, have now been forgotten. The NHS Breast Screening Programme, now in its 19th year, has brought rapid and radical change to breast cancer care in the United Kingdom.

The difference between brilliant advances and heroic failures can only be judged by history.