CASES TREATED BY RADIUM IN THE ROYAL INFIRMARY, EDINBURGH, DURING 1912

'No ordinary meeting': Robert McWhirter and the decline of radical mastectomy

On 7 January 1948, a meeting was held at the Royal Society of Medicine in London. Its purpose was to settle a controversy. Robert McWhirter, an Edinburgh-based radiotherapist, had been invited to defend the scandalous position advocated by Geoffrey Keynes ten years previously: that radical mastectomy offered no survival advantage when compared to simple mastectomy plus local radiotherapy. The negative publicity surrounding the meeting proved overwhelming for Keynes and he abandoned his research. Indeed, the events of the meeting may have been quietly buried were it not for McWhirter who, over the following decade, pursued Keynes' research. He refined his technique, sparing patients the disfiguring and painful radical mastectomy without compromising overall survival. Later, he garnered support from other researchers, which led to a series of papers confirming his original findings. Towards the end of his career, he also made contributions to service organisation and hormone therapy, eventually holding the Presidency of the Faculty of Radiologists. By keeping the controversy alive, McWhirter was instrumental in overturning 60 years of surgical dogma. He remains a pivotal figure in the history of breast cancer.