Diagnosis and Treatment of Lesions of the Breast

Abstract

The educational program which the American Medical Association has sponsored for a number of years has been of great benefit in the treatment of malignant disease. This is evidenced by the constantly increasing number of patients who are seeking medical advice earlier in the course of the disease, and the correspondingly increasing number of patients who deem it advisable to submit themselves to periodic general examination. This program has been particularly effective in influencing patients with early lesions of the breast to seek medical advice. Since the mammary gland is a superficial organ and is easily accessible to examination by the patient, an increasing percentage of patients are coming for examination when the clinical signs and symptoms of malignant disease are difficult to distinguish from those of benign lesions, and the responsibility of the physician is thus increased. The first examining physician must establish a definite diagnosis or at least rule out the presence of a malignant lesion, and he must also see that proper treatment is instituted. The following study of the signs and symptoms of malignant disease of the mammary gland, and the indications and methods of surgical treatment of such lesions, is based on a series of 4,038 malignant cases in which operation was performed between 1910 and 1930; the surgical statistics and results of operations are based on 2,879 cases in which operation was performed between 1910 and 1927, inclusive, thus permitting the compilation of results over a period of five years from the time of operation.