File:The breast- its anomalies, its diseases, and their treatment (1917) (14776931783).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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, we must not concludethat every mass found during the course of such examinations, is a metastatic growth.It is advisable, according to Leaf, to perform exploratory laparotomy in all cases where 570 THE BREAST doubt exists as to the nature of a mass in the pelvis of a woman with cancer of thebreast. We have never met with such indications. Care must likewise be exercisedin eliminating from operation all cases in which the liver or other of the abdominalviscera contain metastatic growths. It is often extremely difficult to determine the pres-ence or absence of upper abdominal metastases in the absence of palpable nodules onthe surface of the liver or in the absence of enlargement of the liver. Handley statesthat epigastric tenderness in a woman with a tumor of the breast should excite gravesuspicion of cancer metastasis. The skeletal system should be skiagraphed, as suggested by Judd, especially thoseparts of it in which metastatic cancer is suggested by the clinical history or by the
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Fig. 20I.—Dorsal view of same patient as is shown in following Frazier. figure. Patient of Dr. Charles H. physical findings. Pain in the knee or hip should immediately suggest the probability ofmetastasis to the ..upper end of the femur, a frequent location for metastatic cancerarising primarily in the breast; lumbago, sciatica, lame back, are often due to cancerousinvolvement of the vertebral bodies in the lower dorsal or upper lumbar regions. Themid-point of the humerus is a frequent site for the lodgment of metastatic cancercells from the breast and this area should always be examined. The chest in par-ticular should be submitted to a painstaking physical and fluroscopic examination.In the presence of a tumor of the breast that has become adherent to the underlyingstructures, a skiagraph should be made of the ribs in relation with the tumor; involve-ment of the latter is an indication of inoperability of the tumor. Mistakes are, of course,inevitable despite the most careful exami

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