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June 3, 1905


JAMA. 1905;XLIV(22):1784-1785. doi:10.1001/jama.1905.02500490060012

There is probably no subject of such great interest from both the academic and the practical standpoints as the dissemination of malignant neoplasms. Notwithstanding the enormous amount of pathologic work which has been lavished on the subject in the last few years, we can still say, with Handley,1 "the subject of cancerous dissemination is in a somewhat hazy and indeterminate condition." In the case of mammary carcinoma, the commonest form met with in general practice, the question of metastases is of great importance, particularly from the surgical point of view. The frequency with which this form of growth gives rise to secondary nodules in the skin, the bones, and the internal organs has long been known, but the route of infection of the bones and internal organs has been a much-disputed question. It is probably true that the generally accepted theory has been that the infection of the axillary