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

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
ermeation along the lymphatics of the So6 THE BREAST deep fascia. It is a positive contra-indication to operation. Some surgeons believe thatembolic invasion of the nodes of the opposite axilla takes place in a small percentage ofcases. A lymphatic trunk which arises in the lower inner quadrant of the breast (seediagram) is said to serve as the means of transportation of the cancer cells. Handleyfound bilateral axillary involvement in 6 per cent, of a series of 422 late cases. The lower cervical lymph nodes were not involved in any of our cases in which thetumor occupied the upper inner quadrant of the breast. This leads us to the conclusionthat the lymph channel described by Poirier and Cuneo which is said to proceed directlyto these nodules from this area of the breast, rarely transports cancer cells, and further-more that supra-clavicular involvement is ordinarily sequential to axiUary metastasis.This is well supported by Handley who found supra-clavicular metastasis in 18 per cent.
Text Appearing After Image:
Fig. igi.—Carcinoma (medullary) of the breast showing retraction of the nipple and invasion ofthe pectoral muscles. (From a specimen in the Laboratory of Surgical Pathology, Medical School ofthe University of Pennsylvania.) of 229 cases in the records of the Middlesex Hospital records (late cases) and in only 13per cent, of 93 Guys Hospital (early) cases. The anterior mediastinal chain of lymph nodes constitute the final group thatreceives aflerents directly from the breast, and which are therefore susceptible to embolicinvasion. Fortunately, these inaccessible structures are rarely invaded in the earlystages of breast cancer and far less frequently than might be expected in its late stages.Torokand Wittelshofer found cancer cells in the mediastinal nodes in only 6.5 per cent,of 366 autopsies. This low percentage in a series of terminal cases is said by Handleyto depend upon the fact that the small calibre of the afferent lymphatics opposes thepassage of cancer emboH. Poirier attrib

Note About Images