William Halsted’s Radical Mastectomy Patients: A Historical Analysis Through Patient Narratives

The radical mastectomy-a surgery pioneered by William Stewart Halsted at The Johns Hopkins Hospital-was the gold standard surgical treatment for breast cancer until the late 20th century. The procedure included the removal of the breast and lymph nodes, as well as the pectoral muscles. The medical debate surrounding the radical mastectomy is well documented in medical journals and secondary historical sources. Also well documented are Halsted's life, surgical innovations, and his long-standing struggle with addiction. Yet, the experiences of Halsted's patients who underwent this procedure remain relatively unexplored. This article utilizes a patient-centered approach to the history of surgery and Halsted by exploring the experiences of Halsted's patients who underwent radical mastectomies. By analyzing correspondence between Halsted and his patients and family available at the Alan Mason Chesney Medical Archives, this article argues that there was a disconnect between what Halsted and his patients considered a cure after the radical mastectomy. Patients wrote to Halsted about restrictions in arm movement, arm swelling, pain, worries about recurrence, and doubts about the surgery. These concerns-which can be tied to current concerns in surgery like patients' quality of life, chronic pain, and lymphedema-show that, despite Halsted's favorable view of the surgery, patients might have seen things differently.