Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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f the breast with subsequent plastic repair of the organ; theprimary incision is essentially the same as that originally described by Thomas. 466 THE BREAST Warren has performed the operation in a considerable number of cases with excellentresults, and we have found it a useful and satisfactory method in selected cases. Warrenwarns against its employment for the removal of large tumors, and calls attention to thenecessity of a thorough and painstaking examination of all parts of the breast in doubtfulcases where cancer is suspected; this especially applies to cases of abnormal involutionin which the greater part of the breast is involved. As regards the use of the method in advanced cases of abnormal involution, we cannotagree with Warren in the safety of the radiating incisions, however numerous, to exposeall of the diseased areas, and to eliminate the possibility of overlooking a small area ofcancer. There is no alternative, however, in cases of this kind if the breast is to be pre-
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FiG. 170.—A segment of tumor- or cyst-bearing tissue has been removed from the breast, and theseveral remaining cysts will be excised in the manner shown in the illustration. Additional radiatingincisions have been made for purposes of exploration. (Warren.) served, except subcutaneous removal of the organ, and when the patient absolutelyrefuses to submit to amputation, this is the method used in cases of advanced abnor-mal involution. The advisabihty of amputation increases as the patient approaches theend of the child-bearing period. We have not found it necessary to perform plastic resection in every case of simpletumor because in a considerable proportion of the cases the growth is so well encapsulatedthat it shells out readily, and it is unnecessary to sacrifice normal breast tissue. Casesdo occur, however, and in considerable numbers, in which the stroma of the breast isfirmly adherent to the tumor, in which event, it is better practice to make a clean cutexcision of a segment

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