File:The breast- its anomalies, its diseases, and their treatment (1917) (14570613477).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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ved after a very extensive operationdoes not alter the facts of the case since these, as we will show later, are most exceptional. 572 THE BREAST Palliative operations are to be considered when the patient is suffering great pain eitheras the result of local ulceration or nerve pressure from a metastatic growth. It is likewise -justifiable to remove a sloughing malodorous mass. Patients withmammary carcinoma who die as the result of internal metastasis undoubtedly suffer lesspain than those in whom toxemia arising from ulceration of the primary growth is theactual cause of death. This in itself justifies excision of ulcerating tumors of the breast. Excruciating pain referred down the arm of the affected side may become an urgentindication for operation. Division of the cords of the brachial plexus has been resortedto under these circumstances and the resulting paralysis has proved less burdensome tothe patients than the pain from which they suffered before operation. It is a debatable
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Fig. 202.—Widespread cancer en cuirasse showing numerous nodules in the skin with involvement ofboth breasts. Patient of Dr. Charles H. Frazier. question whether one is justified in deluding hopeless cases with a hopeful prognosis foroperations that cannot do more than give transient relief. The temporary relief frommental distress that this deception affords is, we believe, sufficient justification forits practice in many instances; the late Dr. Agnew advised radical amputation of thebreast for carcinoma when it was his belief that the operation not only failed to curethe disease but actually shortened the life of the patient, this advice he gave with thefirm conviction that the temporary relief from worry on the part of the patient was alegitimate indication for the operation. On rare occasions it becomes necessary to ligate the sub-clavian artery to arresthemorrhage from an ulcerating mammary carcinoma; in the great majority of cases,however, the bleeding can be controlled by pre

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