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The stratification of patients into operable and nonoperable categories has improved surgical outcome. After attempts to extend Halsted procedure by extended or super-radical mastectomies proved to be of little benefit, a minimally-invasive trend emerged gradually. What is it about breast cancer that has made mastectomy and its effects so hard to discuss throughout history? History suggests that our fear of cancer is deep rooted. Desperate patients put raw meat on the cancerous area in hopes that the disease would eat the meat and not their bodies.
While physicians occasionally diagnosed testicular or skin cancers, internal cancers were impossible to pinpoint in living patients and often had symptoms similar to infectious diseases rife in the period. Cancers of the female reproductive system were slightly easier to diagnose with a physical examination, but the overwhelming majority of all diagnosed cancers were in the breasts. Noticing that post-menopausal women were the most likely to suffer from cancer, physicians concluded that when menstruation ceased, women were vulnerable to a buildup of bad humours, or fluids, in the womb.
Unable to be expelled from the body, this toxic cocktail was, they believed, transported directly to the breasts via a special now known to be non-existent vein. While medicines of mercury and arsenic might be tried, the mastectomy was the only effective means of treatment. Lymph is the fluid carrying white blood cells throughout the body. Lumpectomies were also performed by surgeons, but there was no anesthesia yet. Surgeons had to be fast and accurate to be successful.
Our modern approach to breast cancer treatment and research started forming in the 19th century. Consider these milestones:. The ability to isolate specific genes and classify breast cancer is the beginning of more-tailored treatment options. For example, the Oncotype DX gene profile test can examine part of a tumor to find out which genes are active in it.
Doctors can determine which patients with early stage breast cancer can be treated with antiestrogen therapy alone, and who would need the addition of chemotherapy.
The sentinel lymph node technique identified the first lymph nodes where the cancer could spread. This allows for the removal of fewer lymph nodes. Studies have also found that shorter courses of radiation and more targeted forms of radiation therapy can be just as effective as longer courses of radiation. This includes delivery radiation therapy during surgery for some patients.
Additionally, targeted and biologic therapies may allow doctors to avoid chemotherapy in certain situations. A large study indicated that adjuvant endocrine therapy and chemoendocrine therapy were similarly effective in certain types of breast cancer. According to the American Cancer Society, , women and 2, men were diagnosed with breast cancer in the United States in Early detection and treatment is still considered the best line of defense against breast cancer.
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