Breast Cancer and Restoration History
Breast Cancer has been described as far back as 3000 BC in the papyrus writings of ancient Egyptians.
Huang Di, the Yellow Emperor, was born in 2698 BCE and subsequently wrote the Nei Jing, the oldest treatise of medicine, which gives the first description of tumors and documents five forms of therapy: spiritual care, pharmacology, diet, acupuncture, and the treatment of specific diseases.
Gaspare Tagliacozzi was one of the first plastic surgeons and was appointed professor of surgery and later appointed professor of anatomy at the Archiginnasio of Bologna. A quote from his book, De Curtorum Chirurgia per Insitionem has become synonymous with plastic surgery, "We restore, rebuild, and make whole those parts which nature hath given, but which fortune has taken away. Not so much that it may delight the eye, but that it might buoy up the spirit, and help the mind of the afflicted."
In 1757, Henri Le Dran, a leading French physician suggested that surgical removal of the tumor could help treat breast cancer, as long as infected lymph nodes of the armpits were removed.
In 1874 the US Patent Office issued its first patent for a "breast pad" to Fredrick Cox. Cox’s invention introduced the basic elements of the breast form, a casing filled with an artificial material to substitute for breast tissue.
Marie & Pierre Curie discover the radioactive elements radium & polonium.
While radium is no longer used to treat cancer, it helped pave the way for both diagnosis & treatment of modern day cancers.
Dr. Vincenz Czerny makes the first true attempt at breast reconstructive surgery in Germany.
William Halsted performs the first radical mastectomy.
David H. Patey develops the modified radical mastectomy for breast cancer. This surgical procedure is less disfiguring than the radical mastectomy and eventually replaces it as the standard surgical treatment for breast cancer.
Legislation signed by President Franklin D. Roosevelt establishes the National Cancer Institute (NCI).
Sir Geoffrey Keynes describes the treatment of breast cancer with breast-sparing surgery followed by radiation therapy. After surgery to remove the tumor, long needles containing radium are inserted throughout the affected breast and near the adjacent axillary lymph nodes.
In 1952 Charles Huggins began removing a woman’s adrenal gland (adrenalectomy) in an effort to starve the tumor of estrogen.
In the 1960s, Thomas Dillon Cronin and Frank Judson Gerow, two US plastic surgeons collaborated with
Dow Corning to create the Cronin-Gerow implant, which was a silicone rubber envelope, shaped like a teardrop, and filled with viscous silicone gel.
On December 23, President Richard M. Nixon signs the National Cancer Act, which authorizes the NCI Director to coordinate all activities of the National Cancer Program, establish national cancer research centers, and establish national cancer control programs.
Originally developed in the 1980's by Dr. Carl R. Hartrampf, a TRAM flap procedure involves moving a small amount of the patient's abdominal tissue, including fat and muscle, to the chest, where it can then be used to rebuild the breast mound.
Results from an NCI-supported clinical trial show that women with early-stage breast cancer who were treated with breast-conserving surgery (lumpectomy) followed by whole-breast radiation therapy had similar rates of overall survival and disease-free survival as women who were treated with mastectomy alone.
The DIEP (deep inferior epigastric perforators) flap reconstruction procedure is similar to the muscle-sparing free TRAM flap procedure, but it only requires the removal of skin and fat. Robert J. Allen, M.D., is the pioneer of the muscle sparing DIEP/SIEA/S-GAP/I-GAP perforator flaps .
The Women's Health and Cancer Rights Act treatment of modern day cancers.
(WHCRA) signed on October 21, 1998 requires most group insurance plans that cover mastectomies to also cover breast reconstruction.
The introduction of Acellular Dermal Matrix (ADM) has provided surgeons with alternative means of obtaining sufficient vascularized soft tissue to cover the implant, thereby alleviating some complications. Breuing first reported the use of human acellular dermis in implant-based breast reconstruction in 2005.
The Affordable Care Act has required all new health insurance plans to cover screening mammograms every 1 - 2 years for women ages 40 or older with no out of pocket cost.
The four major subtypes of breast cancer are defined as HR+/HER2 (“luminal A”), HR-/HER2 (“triple negative”), HR+/HER2+ (“luminal B”), and HR-/HER2+ (“HER2-enriched”).
Large meta analysis finds that radiation therapy significantly reduces the risk of breast cancer reoccurrence and mortality. Also in 2011 FDA approves 3D mammograms.
December 18, 2015, President Obama signed the Breast Cancer Patient Education Act which mandates the implementation of an educational campaign for patients and health providers about the availability and coverage of breast reconstruction and other post-mastectomy alternatives.