Table 3. Comments from Celsus and Galen on treating breast cancer 2000 years ago.

Aulus Cornelius Celsus (30 BC–38 AD)

First there is the cacoethes, then carcinoma without ulceration, then the fungating ulcer. None of these can be removed but the cacoethes: the rest are irritated by every method of cure. The more violent the operations the more angry they grow. After excision it recurs, bringing with it the cause of death, whereas at the same time by using no extirpation protract lives, notwithstanding the disorder, to an extreme old age.

Galen of Pergamum (131–203 AD)

We have often cured this disease in the early stages, but after it has grown to a noticeable size no one has cured it with surgery.

Interpretation

Both Celsus and Galen knew about the stimulation of distant metastases after breast tumour removal especially if the tumour was more advanced than ‘cacotheses’. But with cacotheses, a patient could be cured with tumour removal even without benefit of pain or infection control. That was equally remarkable.