ABSTRACT
Until the beginning of the 20th century, the diagnosis of breast cancer relied solely on clinical findings. Thus many cancers were large at the time of diagnosis with a high frequency of metastatic spread, the treatment was limited to surgery and the prognosis was often poor. However, the limitations of surgery alone in offering a cure were recognised – DH Agnew commented in 1883 ‘I do not doubt that cancer will one day be curable, but I do not believe that this will be procured through the surgeons scalpel’.1
