History of Breast Cancer: Then and Now

By Dr. Harit Chaturvedi in Breast Cancer

Oct 10 , 2022 | 2 min read

In the last few decades in oncology, the journey of a breast cancer patient has transformed dramatically. From a time when the only focus was to make the patient ‘cancer free’, science has evolved to the current time: where there is impetus not only on ensuring safety but improving the quality of life of our patients. We have seen a lot of transformation in all fields of cancer management: right from diagnostic services to all pillars of cancer treatment.

There was a time when breast cancer was treated as a single entity: all patients were treated in the same way. Everyone received the same kind of surgery: commonly a Radical Mastectomy, i.e. removal of the entire breast with all lymph nodes in the armpit. The understanding of how breast cancer cells behave was limited, and so were therapy options. The outcomes were poor: especially for those with advanced disease, and the side effects were immense.

Now, we stand at a time where we understand there are a variety of breast cancer subtypes, and each patient deserves treatment which is individualised as per the age, stage, type, subtype, genetic background and a variety of other factors. Breast cancer mortality has decreased by 39% in the last 3 decades.

Surgery for breast cancer patients has also evolved- it focuses on improving cosmetic outcomes with breast conservation, oncoplasty (usage of plastic surgery techniques along with cancer surgery principles) and whole breast reconstruction. The dreaded swelling of the arms (lymphedema), which was very common earlier, has reduced to less than 5-8% with Sentinel lymph Node biopsy (SLNB). We are happy to say that most of our patients return with almost no disfigurement of their breasts or arms.

Systemic therapy has perhaps seen the most considerable growth, with the development of newer targeted therapies, immunotherapy, hormone therapy and tools like next-generation sequencing. This has helped in all types of breast cancer, even advanced cases and aggressive subtypes like Her2 and Triple Negative breast cancers. Newer radiation techniques such as Tomotherapy, Deep inspiration breath hold (DIBH) etc., have allowed radiation oncologists to deliver the best outcomes with minimal side effects.

With the advent of tools like 3D mammograms, MR mammograms, vacuum-assisted biopsy etc., the ability to detect early cancers and plan treatment better has also grown. We have also seen growth in genetic testing, which helps pick up high-risk cancer mutations in families. Closely working with our colleagues in Gynaecology has led to the advent of oncofertility, allowing patients to plan their families even after cancer treatment.

Although cancer remains a dreaded word and disease, and the incidence is becoming more and more common, the rapid change in the field of Oncology is heartening to see. It has helped us serve our patients better and ensure they live free from the fear of cancer without compromising their quality of life. The journey ahead is long, but the last few decades show that we are on the right path.

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