Operative surgery . Fig. 1233.—Excision of the breast. Warrens lines ofincision, a. Incision to clavicle, b. Incisions forsecondary flaps. 1008 OPERATIVE Fig. 1234.—Excision of the breast. Cheynes line of incisionfor removal with central involvement. Cheynes Incisions, etc. (I^^igs. 1234, 1235, and 123G).—It should be notedthat these incisions include not only the skin covering the entire breast, but also a decided increase; of the area at the as- ^^^^ pect of the organ bear- ing the disease. Cheynedoes not carry the in-cision straight downto the muscle, but in-stead dissects up only
Operative surgery . Fig. 1233.—Excision of the breast. Warrens lines ofincision, a. Incision to clavicle, b. Incisions forsecondary flaps. 1008 OPERATIVE Fig. 1234.—Excision of the breast. Cheynes line of incisionfor removal with central involvement. Cheynes Incisions, etc. (I^^igs. 1234, 1235, and 123G).—It should be notedthat these incisions include not only the skin covering the entire breast, but also a decided increase; of the area at the as- ^^^^ pect of the organ bear- ing the disease. Cheynedoes not carry the in-cision straight downto the muscle, but in-stead dissects up onlysufficient of the un-derlying fat alongwith the skin to pre-serve the vitality ofthe latter, tlius leav-ing behind and stillconnected with thetumor the outlyinglobules of the breastand the lymphaticsand vessels containedin the deeper fatwhich are connected with the growth, thereby excluding these elements ofdanger and rendering easier the final closure of the wound. The pectoralfascia is invariably removed and at least a superficial layer of the great pec-toral muscle, along with the diseased gland ^_ and the deep fat, pref- ^^ erably in a common _«^^
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