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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ndency of the tumor may be questioned by the microscopist. An explanation may be found in the intra-vascular condition. If the capillaries ofthe tumor be imperfect, and if the blood circulate among the tumor cells with a tendencyto detach and transport them, manipulation of the tumor can be expected to facilitateboth. The disturbances attending operation may therefore be accompanied by thepassage of an unusual number of the tumor cells into the veins. At the same time theof)eration results in venous obstructions, venous thrombosis, various compressionsand ligations, and the cells in the small veins may be retained locally instead of beingdisseminated. The considerable or inconsiderable number of cells at any point probably has muchto do with secondary tumor growth. As a certain number of bacteria seem to be re-quired to produce infection, so it may be that a certain number of tumor cells are es-sential to the growth of a secondary tumor. Single, dissociated cells entering the circula-
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FiG. 149.—Peri-ductal (complicating) sarcoma. tion may be dealt with as a foreign element and destroyed by the body defences; groupsof cells capable of acting as emboli may contain some able to survive and multiply.It may not be impossible that the greater number of cells retained in the coagulatedblood of the veins or escaped from them into the wound determines that local returnshall take place, while the smaller number that enter the circulation is not adequate to.determine metastasis. Though recurrence may be prompt and frequent, metastasismay not take place at all. Thus in S. D. Gross case, the patient was operated upon22 times for 51 recurrent tumors, during four years, after which she was living and well,without any further recurrences, and with no metastasis for ten years and nine months.The type of tumor has much to do with the early or late occurrence of metastasis.Unfortunately, it is difficult to obtain accurate data upon the subject. Presumably theorder of frequency is r

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