. Modern surgery, general and operative. weat-gland. The sweat-duct is helddown by contracting fibrous tis-sue. This condition is termedpeau dorange, or pigskin saddleappearance. The tumor usuallygrows rather slowly unless lacta-tion is established, when it growswith frightful rapidity. As itgrows it infiltrates adjacent struc-tures (the pectoral fascia, pectoralmuscles, subcutaneous cellular tis-sue, and skin). When a tumor be-comes adherent to the skin theskin becomes congested and of adark purple hue. When the skinis destroyed, an ulcer forms, andaround this ulcer the skin becomesred and fi
. Modern surgery, general and operative. weat-gland. The sweat-duct is helddown by contracting fibrous tis-sue. This condition is termedpeau dorange, or pigskin saddleappearance. The tumor usuallygrows rather slowly unless lacta-tion is established, when it growswith frightful rapidity. As itgrows it infiltrates adjacent struc-tures (the pectoral fascia, pectoralmuscles, subcutaneous cellular tis-sue, and skin). When a tumor be-comes adherent to the skin theskin becomes congested and of adark purple hue. When the skinis destroyed, an ulcer forms, andaround this ulcer the skin becomesred and filled with cancerous nod-ules, which feel like shot in theskin. Metastases are apt to occur in the bones, liver, brain, pleura, lung, spine, thymus gland and rarely theeye. The pleura and lung may be attacked by direct spread of the growththrough the chest wall, from infected rnediastinal glands, or by lymph regurgi-tation from the axillary and subclavian glands. Pain, absent at the start, is usually present later in scirrhous Tig. 1090.—Recurrent carcinoma of the breast. 1586 Diseases of the Mammary Glands It is lancinating and neuralgic in character, and not brought on or increasedby handling. It ceases if colloid degeneration begins. The general healthis usually unimpaired until ulceration takes place, when cachexia arises. In1792 Howard described the condition to which Velpeau called particular atten-tion in 1838 as a deep cancer of the integument due to a cancerous state of thedeep cutaneous lymphatics. Velpeau named it ligneous cancer and also canceren cuirasse (Figs. 1088 and 1089). The cancer en cuirasse of Velpeau is acondition in which the lymphatic vessels of the skin are distended because ofobstruction. The skin thickens as in elephantiasis. The blocked-up lymphcontains cancer cells and the skin early becomes nodular and cancerous. In mostcases the condition is secondary, but primary cases have been reported. Thecondition may arise from cancer in the br
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