Oophorectomy for Breast Cancer: History Revisited

Oophorectomy for the treatment of breast cancer is like taking aspirin for health: it keeps reappearing as an effective therapy with new twists. However, a closer look at the early history of oophorectomy suggests that perhaps the new twists are not new at all. In fact, a brief chronology of the early history of this intervention reveals facts and personages discrepant with common understandings. It is important to note that oophorectomy was not first used as a treatment for breast cancer at all. A German surgeon, Alfred Hegar, apparently the first physician to perform the procedure on July 27, 1872, was treating benign disease. Although in his later work he recognized the physiologic effects on organs other than the breast from surgical menopause, he did not publish on the subject until 1878 (1). An American physician, Robert Battey, first performed a bilateral oophorectomy, which he called ovariotomy, three weeks later than Hegar on August 17, 1872. Because Battey published a report that same year, and thereby established historical priority, the surgical procedure became known as Battey's operation (2). Battey was prompted to carry out this radical surgery because of the death of a young patient whose course of ill health, similar to that of his operative case patient, had been characterized by the absence of regular menses. He reasoned that with removal of the ovaries, the source of the patient's multisystem malady would also be removed.