A Brief History of Metastatic Breast Cancer
Pamela Kaufman | Sept 28, 2017
Physicians have been trying to understand metastatic breast cancer (MBC) for millennia. Looking back over the long history—marked by scientific breakthroughs as well as an extraordinary amount of grasping in the dark—it’s encouraging to think about how far we’ve come, sobering to consider how much we still don’t know. Read on to learn about MBC throughout the ages.
A major archaeological discovery
2200 BC: A woman believed to be an aristocrat from the 6th Pharaonic Dynasty dies and is buried in a tomb in southern Egypt. The skeleton, discovered in 2015, is now the world’s oldest evidence of breast cancer. It shows “the typical destructive damage provoked by the extension of a breast cancer as a metastasis,” according to Egypt’s Antiquities Minister.
Treating breast cancer in the ancient world
1600 BC: An Egyptian physician writes a kind of medical textbook on a piece of papyrus, the oldest such document in existence. Eventually known as the Edwin Smith Papyrus, it describes eight instances of breast cancer that were removed by cauterization.
Is black bile to blame?
460 BC: Hippocrates, the Greek physician known as the father of modern medicine, describes breast cancer as a “humoral disease.” He theorizes that the body is made up of four so-called humors — blood, phlegm, yellow bile, and black bile — and suggests that cancer is caused by the excess of black bile. Treatment consisted of diet, bloodletting, and/or laxatives.
A famous breast-cancer case
1666: Anne of Austria, the mother of King Louis XIV, dies despite receiving the most cutting-edge treatment of her time for breast cancer: the application of arsenic paste and a desperate (and anesthesia-free) attempt at surgery.
The celibacy theory
1713: Italian doctor Bernardino Ramazzini wonders if the relatively high incidence of breast cancer in nuns is due to celibacy. He theorizes that without sex, the reproductive organs, include the breasts, may decay and become diseased.
The first radical mastectomy
1882: William Stewart Halsted, a famous surgeon at Johns Hopkins Medicine, performs the first radical mastectomy, removing the entire breast and the surrounding tissue, lymph nodes, and pectoral muscles. Halsted believes that breast-cancer cells spread in a slow, methodical way, going first to the lymph nodes, then traveling to other parts of the body.
Changing the surgical game
1960s and ’70s: Describing himself as “captivated” by the “mystery of metastasis,” an American surgeon named Bernard Fisher comes to believe that cancer cells spread through the body via the blood and lymph system much earlier than previously thought. He proves that lumpectomy followed by radiation or chemotherapy is just as effective as radical mastectomy.
Advent of hormone therapy
1978: The FDA approves the drug Tamoxifen, originally prescribed as an oral contraceptive, for breast cancer treatment. An anti-estrogen, it is the first in a class of drugs called SERMs: selective estrogen receptor modulators.
A cancer hero
2007: Elizabeth Edwards, wife of presidential candidate John Edwards, announces that she will continue to support him on the campaign trail even after learning she has stage IV breast cancer. She writes about living with metastatic breast cancer in her 2009 memoir, “Resilience.”
Solidarity and strength
2009: Nine members of the Metastatic Breast Cancer Network successfully lobby Congress to declare one day in October — October 13 — as National Metastatic Breast Cancer Awareness Day. One key reason for their activism: Studies on metastasis account for only an estimated 2 to 5 percent of all funds raised for breast cancer research.
The power of genes
2016: Researchers at the Massachusetts Institute of Technology develop a new technique that may correct the gene disruptions that put a cancer patient at risk for metastasis. The next step, they say, is to move on to larger models and then to clinical trials.