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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inor muscle is then freed and divided close to the coracoid process. The nerves andlarge axillary vessels appear surrounded by fat. By carefully dissecting off the fat and glands downwardfrom the clavicle and coracoid process, the axillary vein is e.iposed in its whole extent.. The branches ofthe axillary vessels are grasped with forceps close to the main trunks before they are divided. Withthe left hand the fat and glands are further stripped off the anterior surface of the subscapularis andlatissimus dorsi muscles untU the surface of the serratus magnus muscle appears covering the ribs. Theposterior thoracic nerve (nerve of Bell) and the long thoracic artery which lie on the chest wall, as wellas the subscapular nerves on the posterior axillary wall cannot always be preserved. In this way, byremoving the fat and glands along with the fascia, the axilla appears like a dissecting-room preparation.The incision is prolonged downward below the mamma to the sternum. The fascia and fat are
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Fig. 225.—Illustrating the Rodman operation for mammary carcinoma. Primary skin incision. stripped off the latissimus dorsi and serratus magnus muscles and the costal origins of the pectorali*minor muscle are exposed. These are detached, and the perforating branches of the intercostalvessels are secured with forceps. Passing over the ribs toward the middle line under the pectoralismajor muscle, we reach its thick sternal origin, which along with the breast is separated from the ribsand intercostal muscles. The incision is now made through the skin above the breast and a skin flap is dissected from the sub-cutaneous tissue as high as the clavicle when the clavicular origin of the pectoralis major is divided closeto the clavdcle and the upper costal origins of the muscle cut through. Ligatures are only applied to thearteries and veins close to the main vessels, and also to the perforating branches of the intercostal vessels.In this operation, the a.xiUary glands, the pectoral fascia,

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