. The breast: its anomalies, its diseases, and their treatment . d by our patients after removal of both the sternal and clavicularheads of the pectoralis major muscle as well as the minor muscle and without any muscle 620 THE BREAST anastomosis. Limitation of arm motion after the radical breast amputation is due tocicatrices and not to the absence of the pectoral muscles. Meyers Method.—The original method of radical amputation of the breast devisedby Willy Meyer was identical in all essential details with that of Halsted. He hassince abandoned, as has Halsted, the use of the cut up to the mi
. The breast: its anomalies, its diseases, and their treatment . d by our patients after removal of both the sternal and clavicularheads of the pectoralis major muscle as well as the minor muscle and without any muscle 620 THE BREAST anastomosis. Limitation of arm motion after the radical breast amputation is due tocicatrices and not to the absence of the pectoral muscles. Meyers Method.—The original method of radical amputation of the breast devisedby Willy Meyer was identical in all essential details with that of Halsted. He hassince abandoned, as has Halsted, the use of the cut up to the middle of the clavicle and inaddition has changed the direction of the external incision. For the formation of thelower flap, the incision starts at the point of insertion of the pectoralis major muscle onthe humerus; passes downward and inward a little above the border of the pectoralismajor to the base of the breast, around this to a little over the middle of the body overthe sternum; the flap is turned back until the border of the latissimus dorsi muscle is. Fig. 245.—Skin incision. (Meyer.) exposed. The upper flap is formed; the inner and outer parts of the first incision areunited by an incision along the upper border of the breast. The axillary and sub-c-lavian veins are next exposed; the axillary and subclavian glands with surrounding fatare extirpated. The fourth step consists of the formation of a pedicle over the sternum and theremoval of the mass. Meyer in certain early cases preserves a small stump of the beUyof the pectoralis minor muscle to which the lower two-thirds of the incisional borderscan be stitched, thus materially reducing the size of the defect as well as improving itssurface for grafting purposes. He advises grafting the defect immediatel}^ after the op-eration and states that his practice is followed by perfect mobility of the arm and thatedema of the arm is unknown after the operation. CARCINOMA 621
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectbreast, bookyear1917
