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THE EFFECTS OF DELAY IN TREATMENT ON SURVIVAL RATES IN CARCINOMA OF THE BREAST
Author(s) -
Sheridan Brian,
Fleming Justin,
Atkinson Leicester,
Scott Godfrey
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb87551.x
Subject(s) - argument (complex analysis) , radical mastectomy , disease , breast cancer , medicine , subject (documents) , reputation , mastectomy , psychology , cancer , law , political science , pathology , computer science , library science
The Halsted radical mastectomy enjoyed worldwide reputation as the standard treatment for carcinoma of the breast from soon after its description in 1904 until the 1940's, and its rightness was until then scarcely questioned. In the 1940's the whole subject was widely reexamined; the actual results were shown to be poorer than was generally believed; the anatomical scope of the operation was questioned, and Its technique was modified in several ways. Its fundamental principles were challenged, and even the very worth of treatment itself was questioned, when it was pointed out that vital statistics had failed to show any lessening mortality from the disease over several decades. The challenges were given further support by a modern reawakening of the old argument of whether cancer is a “general” or a “local” disease, and the consequent apprehensions over the futility of treating a local condition if there are general factors which are of greater importance. Orthodox treatment was described as having “failed” (Bond, 1967). The hormonal background of the patient is one of these general factors, which is rightly being thoroughly explored. The possible dangers of interference with the immune response of the patient by removing or irradiating uninvolved axillary glands have been mentioned. All these points, and others, may be valid. There is a risk, however, that the confidence of the 1930's has been so eroded that there is often dangerous procrastination in the institution of treatment. We believe that early treatment remains of fundamental importance, that our figures provide evidence to support this, and that this is an opportune time for the restatement of this principle.