A case of diffuse fibroma with a tendency to intra-canalicular growth of both breasts : operation on each with an interval of three weeks, recovery / by C.B. Porter.

  • Porter, C. B. (Charles Burnham), 1840-1909.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: A case of diffuse fibroma with a tendency to intra-canalicular growth of both breasts : operation on each with an interval of three weeks, recovery / by C.B. Porter. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Physical examination shows she is pale, emaciated, with ovarian facies. Both breasts enormously enlarged. Right breast: largest cir- cumference, thirty-eight inches; length from chest-wall to nipple, seventeen inches; circumference at base, twenty-three inches, j Left breast: largest circumference, twenty-eight inches; length from chest- wall to nipple, fourteen inches; circumference at base, twenty-three inches. Skin oedematous, thickened, and porky. Throughout both are to be felt movable, hardened masses of irregular outline, varying in size from an orange to a closed fist. No tenderness. For two weeks every attention was given to building up her strength for an operation which in size of wound would equal a hip-joint amputation. At the end of that time she was brought to operation. I decided to remove the left and smaller brea‘>t first. Feeling that loss of blood was one of the dangers, I had made two large skewers; with these I transfixed the breast vertically and horizontally close to the chest- wall, and behind them placed a tightly drawn rubber tourniquet. An anterior and posterior flap was made and the breast removed. All vessels large enough to be recognized were tied with sterilized silk before the tourniquet was removed, and little blood was lost. The operation so far was done in the sitting position ; she was then placed upon a table and a few remaining pieces of the breast tissues removed. Continuous silk suture closed the wound, with bone drainage. Six days after the stitches were removed, and there was a slight oozing at two points. Four days later the wound was closed and was dressed with collodion dressing for support. Three weeks after the first operation I removed the remaining breast in the same manner. This was followed by more marked shock than the first, but six hours after she had reacted well and was in good condition. Temperature 98° ; pulse 80. In ten days the dressings and sutures were removed and there were two small stitch-hole abscesses. Convalescence was rapid; in ten days she was strong enough to desire to leave the hospital and visit some friends. There remained two very small granulating spots, and she was advised to report at the hospital soon, in case all did not go well. The sequel of this seems to have been decided by the irony of Fate, for the woman, instead of visiting her friends in the near vicinity of Boston and reporting in two weeks at the hos- pital, decided in a few days to return home, and took, in the middle of winter, a cold and perilous sea voyage. She arrived home the day before Christmas, and called her physician to dress two small spots where the cicatrix had given way since she