Breast cancer-treatment for the future based on lessons from the past

The “modern treatment” of breast cancer historically has been linked to the now famous report presented by William Halsted in Baltimore in 1894 and published in both The John Hopkins Reports[1] and Annals of Surgery[2]. Doctor Halsted had such a profound effect on the treatment of breast cancer that this procedure and his philosophy were never effectively challenged for the ensuing 70 years. While the evolution of the surgical treatment of breast cancer had undergone few modifications in the ensuing 70 years, the last 30 years have produced an explosion of developments in the areas of surgery, radiation, chemotherapy, and genetics such that the multidisciplinary approach we use today is nearly unrecognizable when compared with treatment available prior to 1970. The most significant developments in the era of what I would consider the modern treatment of breast cancer can be broken down into the three general categories of treatment, detection, and prevention.