A Brief History Of Breast Cancer

Breast cancer is the single most common cancer in women in the world. Did you know that? There are, on average, around 55,920 new cases of breast cancer diagnosed every single year, with 11,499 deaths recorded each year. That’s 32 people every day who lose their lives to breast cancer.

Unsurprisingly, this means breast cancer is one of the most heavily studied cancers there is, with billions of pounds, dollars and many other currencies being poured into preventions, treatments and cures. Thanks to this research the way we treat breast cancer has changed over the years, and in honour of Breast Cancer Awareness Day, we wanted to share how those treatments have evolved from the very first treatment, to the present day.

The First Discovery

Breast cancer has been around probably since humans first learned how to walk, but it took a while for us to understand what it was! The first documentation of breast cancer in humans is the Edwin Smith Surgical Papyrus, a medical text which clearly describes cases of breast cancer. This dates back to around 3,000-2,500 BC.

Fast forward a little, and ancient Greeks would make candle offerings in the shape of a breast to the god of medicine. At the same time, Hippocrates (the father of modern medicine) was describing the early stages of breast cancer.

The first treatment for cancer was recorded in the first century, when doctors experimented with surgical incisions to see if they could destroy tumours. They also through that breast cancer was brought on by the end of menstruation – which is where we got the associations between cancer and old age that still plague us to this day!

Surgery fell out of favour during the Middle Ages, with Christians deeming it a barbaric practice and instead performing faith healings.

This didn’t last long though, and the Renaissance saw the revival of surgery. One of the biggest discoveries to impact our understanding of cancer was made in this time period, with Doctor John Hunter (known as the Scottish father of investigative surgery) discovering lymph (the fluid that carries white blood cells around the body) as a cause of breast cancer. He also pioneered ‘lumpectomies’ to remove breast lumps, but without anaesthetic doctors had to be fast and accurate in order to be successful.

Breast Cancer Research Milestones

Most of our modern understanding of cancer and its treatment was based on research that started in the 19th century. In that time there have been some amazing milestones, including:

1882: William Halstead performed the first radical mastectomy. This became the standard treatment for breast cancer and stayed that way until well into the 20th Century.
1895: The first X-ray is taken. This is significant because eventually low-dose X-rays would be used to detect breast cancer. We call these mammograms.
1898: Marie and Pierre Curie discover the radioactive elements radium and polonium. Radium is quickly harnesses for medical use in cancer treatment.
1932: A new method of mastectomy is developed that is much less disfiguring, meaning women can lead a somewhat normal life after the procedure. This became the new standard for the surgery.
1937: Radiation therapy is added into the treatment mix for breast cancer. Once the tumour had been removed, radium-filled needles were placed into the remaining breast tissue and near the lymph nodes.
1978: A new drug called Tamoxifen (also known as Nolvadex and Soltamox) is approved by the FDA for use in cancer treatments. This is the first of a new class of drugs called Selective Oestrogen Receptor Modulators (or SERMs).
1984: Researchers studying rats discover a new gene. The human version, named HER2, is found to be linked with more aggressive forms of breast cancer when overexpressed. This is known as HER2-positive breast cancer, and it isn’t as responsive to treatments as other types.
1985: Researchers discover that women with early-stage breast cancer who were given lumpectomy and radiation treatments have similar survival rates to those only treated with a mastectomy.
1986: Scientists discover how to clone the HER2 gene.
1995: Scientists figure out how to clone the tumour suppressor genes BRCA1 and BRCA2. They also discovered that inherited mutations in these genes can be used to predict an increased risk of breast cancer in individual patients.
1996: Anastrozole is approved as a treatment for breast cancer. This drug blocks the production of oestrogen in the body.
1998: Tamoxifen is found to decrease the risk of developing breast cancer in at-risk women by 50%. The drug is quickly approved by the FDA for use as a preventative therapy.
2006: A new SERM drug called Raloxifene is discovered to reduce breast cancer risk for postmenopausal women (who are at a slightly higher risk). It was also found to have a lower chance of serious side effects compared to Tamoxifen.
2011: A large analysis of data finds that radiation therapy significantly reduces the risk of breast cancer recurrence and dramatically lowers the mortality rate.
2013: The four major subtypes of breast cancer are defined, which helps in identification and treatment. They are HR+/HER2 (“luminal A”), HR-/HER2 (“triple negative”), HR+/HER2+ (“luminal B”), and HR-/HER2+ (“HER2-enriched”).
2017: The first biosimilar drug is approved by the FDA for breast cancer treatment. It’s called Ogivri, and made cancer treatment more affordable and easily available.
2018: A clinical trial suggests that chemotherapy after surgery has no benefit for 70% of women with early-stage breast cancer.
2019: The drug Enhertu is approved by the FDA. This drug proves to be very effective in treating HER2-positive cancer that has metastasized or can’t be surgically removed.
2020: A new drug called Trodelvy is approved by the FDA for treating metastatic triple-negative breast cancer in people who haven’t responded to at least two other treatments.

Modern Treatment Methods

That’s an awful lot of progress! By researching breast cancer, we’ve seen countless breakthroughs in our understanding of cancer as a whole, unlocked dozens of new treatment options and even found some prevention and early detection methods that have significantly impacted the diagnosis and survival rate of breast cancer.

As doctors learn more about the disease, breast cancer treatment is becoming more personalised and effective. We’ve discovered more subtypes, studied how it can impact the body, and we can even isolate specific genes to aid in treatments. This means we’ve been able to develop more specialised tests, like Oncotype DX - which examines part of the tumour and tells doctors which genes are active, therefore which treatments will be most effective. And we have less invasive and toxic treatment techniques, including shorter courses of radiation, targeted biologic therapies and the sentinel lymph node technique, all of which improve the effectiveness of cancer treatments.

But of course, there’s still a long way to go. At Jill’s Fundraising Journey we provide free holidays for anyone affected by a cancer diagnosis – not just breast cancer. We also provide resources and support for those with cancer, or with a loved one battling cancer. If we can help ease your journey in any way, we will. If you would like to help us by raising money for Jill’s Fundraising Journey this month, we’d love to chat through your ideas!