Abstract of a paper on excision of the breast for cancer / by W. Watson Cheyne.
- Watson Cheyne
- Date:
- 1892
Licence: Public Domain Mark
Credit: Abstract of a paper on excision of the breast for cancer / by W. Watson Cheyne. Source: Wellcome Collection.
Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.
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![EXCISION OF THE BREAST FOR CANCER* [REFEBEifCE was in the first instance made by Mr. Cheyne^ to work done on this subject, especially from the pathological side, by various writers, notably by Dr. L. Heidenbainf in Germany and Mr. Harold StilesJ in Edinburgh, the methods advocated being based'in the main on Mr. Stiles’ work. A few remarks having been made on the question of the constitutional or local origin^of cancer, Mr. Obeyne went on to discuss the exact nature and mode of spread of a cancer of the breast as follows :] The view which I think is generally held is that the carcinoma begins as an overgrowth of epithelium in the acini or ducts of the breast, and that it spreads partly by epithelial projections from these acini or ducts pushing then’ way into the surrounding tissues and partly by fresh infection of neighbouring ducts or acini; and further, that the same overgrowth of gland epitheliuin which produced the original disease is liable to occur in other parts of the breast, giving rise to multiple breast tumours, and that it is to this fresh overgrowth that local recurrences are most commonly due where portions of breast tissue are left behind. The latter part of this view is, i believe, incorrect. No doubt the earliest commencement of a cancer must be in connexion with the gland epithelium, but I believe that once the disease has commenced the epithelial overgrowth soon pushes its way through the wall of the duct or acinus aud passes then into the lymph channels and vessels surrounding it, and that having arrived there the subsequent growth of the tumour occurs entirely by multiplication of the original epithelial cells and their derivatives along these lymph channels. The cancerous tumour is, in tact, a growth in lymphatic canals, and the alveolar spaces are in the main ddated lymph vessels and spaces. Hence the cancer cells are in direct com- munication with the lymph stream from a very early period of the tumour formation, and are constantly liable to be carried away with the fluid lymph; and may either stick further on, giving rise to secondary nodules in the breast or surrounding fat and fascia, or may be carried to the nearest lymphatic glands, causing infection and tumour formation there. The neighbouring acini around a tumour do not form fresh growth ; hut, as can be frequently seen in microscopical specimens, they are simply pushed aside, undergo atrophy, and disappear. It can also be readily * Read at the Nottingham Medioo-Chirurgical Society on April 20th, 1892. t Langenbeck’s Archiv, vol. xxxix., 1889. J Edinburgh Medical Journal, June and July, 1892. 1](https://iiif.wellcomecollection.org/image/b21303459_0003.jp2/full/800%2C/0/default.jpg)
