Breast Cancer in Ancient Greek & Byzantine Medicine

Herodotus reports that Democides, a famous physician of the time, while serving at the Persian palace (520 BC), cured King Darius' wife, Atossa, of breast cancer.

Whatever it is, the way you tell your story online can make all the difference.

Whatever it is, the way you tell your story online can make all the difference.

Hippocrates (460 - 377 BC) describes hard infiltration of the cervix, but makes only an incomplete mention of breast cancer: Hard tumors develop in the breast, which do not infiltrate, but become steadily harder, and from which hidden cancers later develop. He considers the prognosis of the disease relatively good if treated in the early stages and if the woman is still menstruating.

Celsus (30 BC - 50 AD) defines the term cancer even more precisely in his writings and mentions the swelling of the lymph nodes in the armpit in the case of breast cancer. He refers to the surgical treatment of the disease and recommends not removing the pectoralis major muscle (the large muscle of the anterior chest wall) during surgery.

Archigenes (54-117 BC) gave a very clear description of breast cancer, which was used until the 18th century.

Soranos from Ephesus (2nd century AD), the most famous obstetrician-gynecologist of his time, does use vaginal dilators to examine the cervix (which Jewish physicians and Archigenes were also in the habit of doing), but in his writing "On Diseases of Women" he does not give any particular information".

Galen (121-223 BC) describes surgery for breast cancer. He uses the scalpel for resection, presses the wound to stop the bleeding, then cauterizes it for the same reason and, as he says, has good results. In general, Galenos does not see the possibility of a cure through surgery, as he believed that cancer is a disease of the mind (internal dysfunction).

Leonidas of Alexandria (180 AD), although his writings are lost, distinguishes, as Aetios mentions, two types of malignant diseases of the breast and one of them is cancer. He is the first to describe the characteristic clinical sign of breast in the development of breast cancer. Contrary to Hippocrates' advice (followed by physicians for many centuries) that treatment of ulcerated cancer should be avoided, Archigenes differentiates and operates on them. Aetius from Amida, in his book "on the diseases of the womb" records the cancer operation according to Leonidas.

Paul the Aeginian (625 - 690 AD) distinguishes cervical cancer from uterine cancer. He uses a colposcopy and calls the examination of the cervix "diopterism". Paul, although not an advocate of surgical treatment of cancer, recommends and applies surgery for breast cancer.

In summary, breast cancer was well studied by the physicians of Ancient Greece and Byzantium. Some historians even claim that breast cancer was the model for the study of malignancies, both because of its frequency and its position in the body. The comparison of the disease with animal cancer has its most accurate representation in the case of the breast. Surgical treatment was easy to apply because the disease was visible, there was no danger to life, there was no high risk of bleeding and the cure was more easily accomplished with fewer complications. The excision of the tumor had to be done in healthy tissue and the cauterization applied afterwards had a double task, on the one hand to stop the bleeding, on the other hand to burn any remnants of the tumor.

Although the historical reference was limited to the Greek physicians of antiquity, it would be an omission not to remind the reader who was attracted by the study of the history of cases of breast cancer surgery, of other physicians of the sixteenth century, namely: of Hieronymus Fabricious, a professor at the University of Padua (who operated radically on breast cancer, with a spindle incision ligating the bleeding vessels), of Frenchman Jacques Guillemeau (who, for greater radical exclusion, also operated on the great pectoralis muscle. He also mentions the case of a 35 years old woman who lived 12 years after surgery), and the German Fabricius Hildanus (who performs lymph node dissection in the armpit in addition to the mastectomy).