1894, a memorable year; Halsted, a name never to be forgotten. This was the year that Halsted, the great Western medical scientist, created the radical mastectomy. For more than 100 years, the Halsted procedure has been the standard of care for breast cancer and has been the basic template for breast cancer surgery since then. Li Bili, Department of Breast and Thyroid Surgery, Affiliated Hospital of Inner Mongolia Medical University Halsted, a surgeon with a clean, well-groomed beard and thin cheeks engraved with gleaming eyes, was born to treat breast cancer. He was born for breast cancer treatment and is a blessing to breast cancer patients. In treating breast cancer patients, Halsted noticed the relationship between the phenomenon of swollen axillary lymph nodes and breast cancer. It is believed that axillary lymph nodes are the way for breast cancer cells to spread throughout the body. He tried to remove the breast and axillary fat together – the classic Halsted radical mastectomy was born. This procedure improved the five-year survival rate of breast cancer patients from 10%-20% to 40%-50%. This was a truly astonishing figure. Soon after, this procedure was followed by extended radical surgery. Perhaps “Huo Lao” himself did not expect that this procedure he created would dominate the history of breast cancer treatment for 100 years. One can imagine how many mothers, wives, daughters, and families that were about to be broken have benefited from this treatment in the 100 years of history, and how many of them have been able to enjoy the happiness of their families again. This successful operation was at the same time an extremely brutal one, which required a wide range of excisions in order to achieve a radical cure. It included all of the breasts, the fat of the chest wall, the pectoralis major and minor muscles, the fat of the armpits, and the lymph nodes that were hidden there. Branches of blood vessels and nerves that did not necessarily seem necessary at the time or could not be preserved according to the requirements of the surgery – parts that had been integral to the maintenance of their body’s structure and vital activities – were also removed as a result of the cancer. In some cases, it is also necessary to open up the rib cartilage and remove the lymph and fat hiding there, so that no cancerous cells can escape. In order to ensure that the surgery is thorough, doctors also work to eradicate the soil where cancer cells can thrive – in addition to removing large chunks of skin on the surface of the breast, the fat underneath the skin has to be picked out to prevent the cancer cells from lurking there and growing at a later date. However, what did people see after the surgery? The skin, overstretched and deprived of adequate nutritional support, first began to redden at the edges, then became dark red or purple; then, it began to soften, became less shiny, and in some cases blistered. After a few days, a dull, dark gray scab appears. The doctor’s hemostat or forceps are clamped over it, the beauties’ eyes do not blink, there is no hint of pain, and even if scissors are used to cut away these blackened tissues, not a drop of blood will come out – because they are necrotic. This is the most common and least serious complication of this procedure – skin edge necrosis. The end result is a wide, ugly scar on the chest. Often times, doctors have to do skin grafts on the missing breasts. Swelling of the upper limbs is inevitable due to the severely damaged lymphatic system. The backs of their hands were like bread, their arms were like calves, they could no longer wear normal-sized clothes, and their skin was unsightly and rough. To this day, lymphedema remains an unsolved problem in breast cancer surgery. Women who have breast cancer sacrifice their beautiful breasts, and there is a hint of sadness in the smiles of those who have overcome the cancer. The breasts are gone, the chest muscles are gone, and a collapsed forehead replaces the perfectly constructed curves of the breasts. A daunting scar ran from the collarbone all the way down to the overlying ribs, one protruding dramatically from the other. No one can appreciate the pain these beautiful women have suffered, and it’s hard to imagine the psychological stress they have endured in the past and in the days to come – the misery that comes from disease and the loss of breasts. For thousands of years, medicine, as a special category of natural science, has accompanied the growth of human society in the footsteps of blood and tears, injuries and pain, in the midst of failure and exploration, success and progress. Relentless efforts always lead to new creations, new advances. The doctor’s relief is to be able to do more and do better for his patients. The people who have benefited from medicine have regained their lost joy. Medicine is still marching on, for those who are waiting for his gospel. (To be continued)