File:The breast- its anomalies, its diseases, and their treatment (1917) (14756759312).jpg

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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Text Appearing Before Image:
. If necessary, the clav-icle must be divided, the supra-clavicular triangle thoroughly cleaned out, and the bone wired (Made-lung). If closure of the wound is impossible, Kocher appUes Thiersch grafts. The Rodman Operation. A straight incision is made beginning i inch below the clavicle, twofingerbreadths from and parallel with the sulcus between the deltoid and clavicular portion of thepectoralis major muscles. It extends well below the free edge of the pectoralis major muscle, and inextent will usually be from 5 to 6 inches or more, according to the stature of the patient and thesize of the breast. It is rapidly carried down through skin and superficial fascia covering the greatpectoral muscle. No hemorrhage of consequence is encountered thus far. I prefer to place this in-cision not too close to the arm, for, in my judgment, incisions extending on to the arm result incicatrices, which often seriously interfere with the future usefulness, and less frequently cause edemaof the limb.
Text Appearing After Image:
Fig. 26.—Illustrating the Rodman operation for mammary carcinoma. Division of the pectoralismajor muscle near its insertion. The index-finger of the left hand is now introduced beneath the lower border of the tendon of the greatpectoral muscle and made to emerge above its upper border, or in the interval between the costal andclavicular portions, if one wishes to remove only the costal origin of the muscle, and division of the tendonat or near its insertion into the humerus. This may be facilitated by dissecting up the external flapslightly and using retractors. I myself see no reason for removing the clavicular portion, in the averagecase, and, therefore, leave it unless the growth is peripheral and in the upper hemisphere. Then un-questionably the entire muscle should be sacrificed. Only a slight dissection will be necessary to exposethe lower edge of the tendon of the pectoralis minor. This should be clearly identified and separated fromthe fascia covering the tendon and below it

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