24 THE TONER LECTURES. 



gland into cysts is an exceedingly frequent occurrence in can- 

 cers of the breast, and I exhibit illustrations taken from two 

 other cases. (Three photographs, Nos, 42 to 44, shown.) 



I have spoken of the ordinary anatomy of scirrhus of the 

 breast. This has been so frequently described that it must be 

 familiar to you all. A stroma of connective tissue encloses 

 alveoli or spaces which are stuffed with larger or smaller, more 

 or less irregular cells. I wash particularly, however, to insist 

 upon the point that these alveoli are not blind cavities, but 

 communicate with each other so as to form a net-work. The 

 net-work is best seen as such at the peripheral portions of the 

 growth, but it can frequently be made out with more or less 

 distinctness in all parts. The cells which compose it are often 

 deficient in the distinct cell-wall which we recognize in many 

 parts at least of epithelial cancers ; they are rather to be de- 

 scribed as little masses of protoplasm, with nuclei embedded, 

 and the branching C3'linders which we found no difficulty in de- 

 scribing as cell-cjdinders in epithelial cancer, are here, very 

 often at least, best described as "nucleated C3dinders." 



Two cancerous tumors of the breast, made up almost wholly 

 of a net-work of such nucleated cylinders lying in an abundant 

 stroma of connective tissue, were described by me in a report 

 to the Surgeon General, to which I have already referred.* I 

 exhibit a photograph from one of these growths. (One photo- 

 graph, No. 45, shown.) 



The other case mentioned in the report was particularl}?^ 

 interesting because after the extirpation of the right breast 

 another tumor formed in the left, and the disease subsequently 

 generalized itself, secondary tumors appearing in the liver, the 

 spleen and the ovaries. 



In both the liver and the spleen the secondarj^ tumors were 

 very small ; smallest in the liver, in which they varied from 

 the size of a pea to that of a pin's head. They were com- 



*See note on page 11, supra. 



