File:The breast- its anomalies, its diseases, and their treatment (1917) (14776885813).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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n a very inexact stage indeed when we are able to get to- CYSTS OF THE BREAST 291 gether and place before the reader the results of pathological examination of 45 breastsof which only four showed mild adeno-cystic change, and only seven epithelial prolifera-tion into cystic spaces, while 34 were entirely benign cases of normal or senile involution. Treatment.—If the symptoms are such as to arouse the suspicion that carcinomamay be present or impending, the upper half of the breast should always be exploredby transcutaneous incision, the lower half by a Thomas incision and plastic resection,reinforced by the microscopic examination of a frozen section. If the smallest area of carcinoma be found, the case is no longer abnormal involution,but carcinoma and should be dealt with accordingly, and the radical amputationperformed. If there be no carcinoma, but the disease be widespread and the breast riddledwith cysts of small size filled with grumous contents, and these cysts surrounded by
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Fig. 126.—Subcutaneous excision of the breast with excision of the anterior pectoral group of lymphnodes. Case of abnormal involution. more or less indurated areas of doubtful character, there is enough justification for theremoval of the breast by simple (conservative) amputation, no attention being paid tothe fact that no carcinomatous disturbance has been found. If the generalized disturbance be slight, but somewhere—usually at the peripheryof the breast—there be an area of tissue condensation containing cysts, that area shouldbe excised. If there should be several such areas with what seems to be healthy inter-vening tissue, each may be cut out, after which the breast may be replaced, sutured anddressed. Reflections upon Abnormal Involution and Its Relation to Carcinoma.—i. We are not suffi-ciently well informed concerning such changes in the mammary gland as may depend upon age andactivity, to separate the normal from the abnormal with certainty. 2. Abnormal involution ma

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