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The Medical Aspects Of Carcinoma Of The Breast, With A Note On The Spontaneous Disappearance Of Secondary Growths

Osler, W. 1901Breast cancer

American Medicine: April 6 1901; 17-19; 63-66

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Abstract

The consulting physician sees mammary cancer at two stages of its progress. Dreading the surgeon, and hoping against hope, a number of women prefer to come to him at the first detection of a tumor. But these form a small fraction of the cases. A large majority are the unhappy victims of the internal metastases after operation. For some years I have been interested in this class of cases, and have collected material bearing upon the question of these late, and more strictly medical, manifestations of the disease. In this paper, fourteen cases of carcinoma of the breast are reported in which there were secondary growths and in some cases the secondary growths spontaneously disappeared.

Case Details

Personal Characteristics

Miss x., aged 31

Clinical Characteristics

Tumor in right breast, pains in the back and down the legs, recurrence in the right eye, orthopnea, emaciation, recurrence in the left breast, tumor mass on sternum, effusion in right pleura, vision difficulty in right eye, shooting pains about the sides, cough, tenderness about the fourth and fifth dorsal spines, distinct tumor in the bone, extensive pleural effusion on the right side, dyspnea, lump in the left breast, distinct prominence about the fourth and fifth dorsal spines, back stiffness, exaggerated knee jerks, pain in right leg

Remission Characteristics

Gradual improvement, disappearance of tumor on sternum, improvement in vision of the right eye, less intense pains, gain in weight, ability to walk about, disappearance of tumor on the sternum, no local recurrences, no increase in the tumor in the left breast, progressive improvement in the vision of the right eye

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Operation november 1897, scirrhus, most extensive radical operation, excision of part of axillary vein, morphia for pain management

Additional Notes

The patient had a fall from her bicycle which was initially attributed to the lump in her right breast. The patient was treated at the Johns Hopkins Hospital by Dr. Halsted. The patient's father was under the care of Dr. de Schweinitz.