Breast cancer in antiquity

To the Editor: Retief and Cilliers stated in their interesting article1 that ‘Evidence of cancers in the Egyptian papyri is very uncertain, but the occurrence of the word weshau (eating) may on occasion be interpreted as indicative of malignancy, and breast cancer may have been recognised.’

This view is contrary to that held by others, which seems quite specific about breast cancer. The Edwin Smith Papyrus2 was written about 5 000 years ago, and is quoted by many. The relevant description is case 45, which has various subheadings (rubrics) in red hieratic:

TITLE: Instructions concerning bulging tumours of the breast.

EXAMINATION: If thou examinest a man [person] having bulging tumours of the breast, and [thou] findest that swellings have spread over the breast; if thou puttest thy hand upon ... these tumours, and thou findest them very cool, there being no fever at all therein ... they have no granulation, they form no fluid, they do not generate secretions of fluid, and they are bulging to the hand ... [from a gloss] touching them is like a ball of wrappings, the comparison is to a green haemat-fruit [probably pomegranate] which is hard and cool under thy hand.

TREATMENT: There is no [treatment].

David Dent

Emeritus Professor of Surgery

University of Cape Town

dmdent2@mweb.co.za

1. Retief FP, Cilliers L. Breast cancer in antiquity. S Afr Med J 2011;101:513-515.

2. Breasted JH. The Edwin Smith Papyrus. Chicago: University of Chicago Press, 1930. Vol 1, case 45:463.