Wednesday, May 19, 2010

Historical background of Breast Cancer

Breast cancer is an old disease, and in almost all periods of history was mentioned. Doctors have found that breast cancer visible, even for the novice, rising from a small set of large tumors. In contrast to other fatal diseases (heart disease and most other cancers), breast cancer was announced in tangible ways (Leopold, 1999). But despite the importance of the disease and of breast cancer had a significant impact, particularly for women and society in general, any discussion of breast cancer has been observed that in the decade before the medical journals 1970s.
Historically, chest, brings many cultural expectations of women, in particular, sex education and its duties. Perhaps it is because the mother has such a power of culture, that the disease was considered by many to be a taboo subject and many victims are too embarrassed to openly about the disease. This gap in the earlier literature outside of medical journals is clearly opposed to the presence of the disease visible in contemporary culture. Today it is a public forum in which breast cancer is not in dispute (Leopold, 1999). Since the success of the lobbying of Breast Cancer in the 1990s, a symbol of Breast Cancer - Pink Ribbon - in American culture everywhere, and the politicians and health officials are recognizing the role that political and cultural assumptions in search of a cure.

In old Egypt and Greece: Breast Cancer while a general Disease

The ancient Egyptians were the first to acknowledge the disease for more than 3500 years. Both Edwin Smith and George Ebers Papyrus contains descriptions of conditions that are consistent with modern descriptions of breast cancer. For example, an unnamed surgeon of ancient Egypt describes bulging tumors on the chest, and says there is no cure. In 460 BC, Hippocrates, the father of Western medicine, cancer, described as a humoral disease. In other words, from Hippocrates, of the body is of four humors (composed of blood, phlegm, yellow bile and black bile), the basic elements of nature (air, fire, water and earth) - and humeral imbalance caused by disease or reflects even lead to death. Hippocrates was for cancer by an excess of black bile or melonchole causes. This logic is the logic of Hippocrates, because the incidence of breast cancer is untreated in black and hard, eventually erupting through the skin with a black liquid. He called karkinos cancer, have a Greek word for crab, because the tumors appeared tentacles, like the legs of a crab. Hippocrates dangerous operation because she had the tumor removed spoil quickly, while those that are not removed lived longer (Olsen, 2002).

In 200 AD, Galen, the successor of Hippocrates, also describes the cancer to the black bile, but in contrast to Hippocrates, Galen also recognized that some tumors are more dangerous than others. Galen also described a broad range of medicines for breast cancer, how to treat opium castor oil, licorice, sulfur, and a variety of ointments and incantations to the gods. Humoral for doctors, the surgery to remove the tumor in the breast or the whole is always more than one option for a cure, because it means the cancer has appeared near the site of surgery or other authority. For Galen and doctors in the next 2000 years, breast cancer is a systemic disease, it was a disease in the whole body, not just a localized part meant. black bile is considered over the whole body. Even if a tumor is removed, bile remains in the body, ready to create more tumors.

Until the seventeenth century, took the doctors that Galen had the last word about breast cancer, and there was nothing more to discover. But in 1680 the French physician Francois de la Boe Silvio the humoral theory of cancer began with the argument that cancer changes came not from an excess of black bile question, but a chemical process that Acre acid lymphatic fluid. In the 1730s, the Paris-Claude Gendron Deshais doctor also rejected the theory of humors, and insisted that cancer develops when nerve tissue with the lymph vessels and glands (Olson 1999) is mixed.

Surgery of the 18th Century: Breast Cancer while a Localized Disease and the arise of Surgery
In 1769, the theory of humors was lost much of its currency. To refute the humoral theory, has the French doctor Jean Astruc, a piece of tissue from the breast with a piece of beef, and burned both in the oven and eat. Both had the same taste, and found the tumor tissue not an unusual volume or bile acid contained. refused by the theory of humors, doctors began to look for a new source of breast cancer, and many argued that their origin was sexual. The doctors knew in 1713 Bernadino Ramazzini, the hypothesis that was the high incidence of breast cancer in nuns because of the lack of sex after Ramazzini no regular sexual activity, reproductive organs, such as breast-have started to fall and the cancer was the result. Frederick Hoffman of Prussia, that women who regularly have sex, but sex can still develop cancer lymphatic obstruction strong.

But other theories were not sexual are also presented. Giovanni Morgagni debt Quark. Johannes de Gorter in the 1750s said that the tumors are swelling with pus in the chest, mixed with the blood-filled stay in the mammary gland, and dried in a tumor. Claude-Nicolas Le Cat Rouen said depression, cancer of the blood vessels constrict and the blood coagulated causes. Lorenz Heister placed childless women with high risk, whereas others blame sedentary relaxing the body fluids. Although there is no shortage of theories, the cause remains a mystery of cancer, that it was for the old. But different than the old, the doctors of the eighteenth century became more confident that breast cancer is a localized disease. This had enormous consequences, because unlike humoral theories as tangential mastectomy systemic treatment of cancer, doctors are now somewhat skeptical but surgery (Olson 1999).

In 1757, said Henri Le Dran, an eminent French physicists, this deal could actually cure breast cancer, provided that the lymph nodes were removed axillia. Similarly, said Claude-Nicolas Le Cat the knife was the only way to cure cancer. The Cat in the amputation of the breast, lymph nodes, cut, and the pectoralis major. These doctors were convinced that the presence of a tumor is not necessarily a major problem, but it was a disease from a single website that can be surgically removed locally before transmission. This theory lasted well into the twentieth century and led to the creation of a radical mastectomy (Hellman, 1993).

William Halstead and the basic Mastectomy image

A mid-nineteenth century, most doctors said that was located since the cancer, the surgery was the only hope. The development of antiseptics, anesthesia, increased blood transfusion and cell biology - and the confidence of the public in the field of medicine - has made possible radical surgery. The days of pre-anesthetic effect of speed and skill are often resistant to a patient. Surgeons have had time to deliberate precision, William Halstead, and New York radical breast surgery, the gold standard for the next 100 years. Halstead wanted to reduce the recurrence of the disease patients often suffer from less than a year to help the first operation and, even more advanced disease caused. As the top surgeons breast, axillary nodes and chest muscles, that was not enough to remove Halstead. He knew that the cancer cell is a sickness, and worry about its own role in the spread. He argued that lifting the breast surgeon's hands are probably scattered away from tumor cells. This has led to the request of a radical breast mastectomy removal Axillary lymph nodes and chest muscles in one single block. Generous cut around the tumor, the removal of all tissue in one piece.

During the first four decades of the twentieth century, dominated the radical mastectomy to treat breast cancer. Halstead has conducted hundreds of radical mastectomy and demanded that women be imposed a radical mastectomy before the cancer spread to regional lymph nodes. Although radical mastectomy of life may have increased a little, and relieves the pain of patients within this was not an unmixed blessing. Some women avoid surgery because it would leave them wounded and disfigured for the rest of their lives. Women have a deformed chest wall, hollow, hollow removed under the collarbone and armpit, pain, and chronic lymphedema or swelling in the arm due to lymph node under his arm, face, and not as fluid of the circulatory system have been treated effectively. Halstead dismissal of these effects as a necessary evil, was also the average age of over fifty-five years [and] hey are no longer active members of society (Olson 1999).

Halstead also asked to reflect on the shoulder of the amputation. For Halstead, and his followers, increasingly tissue was the only way to treat breast cancer. Jerome Urban, the architect of the super-radical mastectomy in 1949, removing the breast, axillary nodes, breast and internal mammary lymph nodes in a single procedure, which are often wide in patients with tumors of less than one centimeter.

Surgery of the twentieth century: Oophorectomy, Adrenalectomy, and Hypophysectomy

In 1895, Scottish surgeon George Beatson found that removal of the ovaries of one of his patients has been reduced tumor of the breast. These new and soon spread surgeons carrying out a prophylactic oophorectomy, the removal of both ovaries and the achievement of a radical mastectomy involves. The operations are small and unpredictable results, as the surgeon's no way of tumors had estrogen receptors. For this reason, in 1920, most surgeons use a castration only as a last resort. The modern oncologists now know that some breast tumors have estrogen receptors that feed on estrogen. Removal of the ovaries, in some cases, the tumor from hunger, at least temporarily. The tumor grows back on, because the body compensates by secreting estrogen substances, such as adrenal and pituitary glands. In 1952, at the same time as the super-radical mastectomy Urban, Charles Huggins began a womans adrenal glands (adrenalectomy) in an attempt to starve the tumor to escape from estrogen. Rolf Herbert Olivecrona Lefft hypophysectomy and started the show, or the removal of the pituitary gland. Side effects include visual disturbances, personality changes and cognitive difficulties. Even with these extreme surgery, returned to destroy tumors.

A new beginning: the task of the Halstead mastectomy

Halstead mastectomy was on the premise that breast cancer is a localized disease that could surgically remove the diseased part of the body are treated is based. George Crile in 1955, began to argue that the cancer was not localized, but spread throughout the body. Bernard Fisher, the treatment of cancer, revolutionized by a review of theory of metastasis, such as Hippocrates, argued that cancer cells travel through the circulatory and lymphatic system, and that the surgery can not cure, because it has cancer cells in the body in the floating added System the circularity. In 1976 Fisher published the results show that breast-conserving surgery or chemotherapy is followed by simple radiation therapy as effective as radical mastectomy, and more generally (Hellman, 1993). The argument for a systemic breast cancer, Fisher, and Crile surgeons directly into question the role of the main sources for the treatment of breast cancer. However, doctors were reluctant to give up the Halstead mastectomy until the sexual revolution and of modern feminism.

The decline of the Halstead radical mastectomy and a revised theory of metastasis, has completed the acquisition of doctors about the origins of breast cancer in the 1990s, everything in the food, chemical pollution, race is been discussed delayed childbirth and breastfeeding. Despite this uncertainty, there is still progress. After an initial increase in the amount of breast cancer, the number of deaths in 1995 remained stable, then began to decline. In 1995, underwent less than 10 percent of women with breast cancer a mastectomy performed. The improved chemotherapy, radiotherapy, hormone therapy (including tamoxifen), mammography and breast cancer surgery has helped to move a disease to a chronic state of emergency. Significantly, the scientists isolated the genes cause the breast cancer: BRCA2 and ATM. Today, advances in molecular and genetic science creation of new therapeutic approaches that men and women not only hope, but also provide more options in their bodies.

New hope for the 21 Century: Changing the public perception

The cure for breast cancer remains elusive. The disease is so complex and so diverse, so subtle to genetic and environmental variables, a cure at a distance can often seem impossible linked. Although no cure has been found, the public perception has changed substantially surrounding breast. As soon discuss a disease, the women were embarrassed to breast cancer has lost much of its stigma and recognize provides the opportunity for politicians and health officials that economic and political considerations about the success of the treatment of breast cancer and the progress of medical science.


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