ABSTRACT
A Treatise on the Disease of the Breast and Mammory Region. London: Sydenham Society, 1856 (Translation by M Henry of Traite des Maladies du Sein et de la Region Mammaire. Paris: Masson, 1854). In: Silvergirl’s Surgery – The Breast (Robbins GF, ed). Austin, TX: Silvergirl, Inc., 1984: 37-44
Reference
Alfredo-Armand-Louis-Marie Velpeau (1795-1867), one of the most highly regarded surgeons of his era, wrote extensively, and persuasively argued the case for surgical management of the disease. This is a very detailed description of ‘radical’ surgical techniques pre-microscope, pre-anesthesia, and pre-Halsted. Velpeau recommends removal of the tumor en bloc with wide margins along with skin and lymph nodes when the tumor appears to extend to these areas. He classified breast tumors on the basis of their physical characteristics and recognized the importance of lymph node involvement. However, he also recognized that lymphadenopathy could represent either involvement by tumor or an inflammatory reaction. This article includes a description of many non-surgical approaches such as bloodletting, purgatives, hemlock, arsenic, iodine, gold, and quinine that were popular at that time. Velpeau wrote long before objective evidence was required to bolster arguments for or against a particular treatment. He argues that results from surgery are superior on the basis of either his experience with or his ‘natural disinclination’ toward various non-surgical approaches.
