710 



THE REPRODUCTIVE ORGANS OF THE FEMALE. 



cuboidal or cylindrical (Fig. 466), and the other in which the cells pro- 

 ject into the lumina in irregular masses (Fig. 467). 



Sarcoma. These tumors may develop in a nodular or diffuse form 

 and may largely replace the gland, or may form intracanalicular growths. 

 They may be of the round or spindle cell type ; they often become very 

 large, and ulcerate. Metastasis in the axillary lymph-nodes is usual. 



Primary Carcinoma of the mamma is most common in women between 

 the ages of thirty-five and fifty-five, but it sometimes occurs in women 

 not over twenty, and sometimes in old persons. It occurs in either 

 breast, in the right rather more frequently than in the left, but some- 

 times in both. The growth begins more frequently at the periphery of 

 the gland than at its centre, and more frequently in the upper edge of 

 the gland than in any other place. 



The growth most frequently begins as a small, circumscribed nodule, 

 which enlarges and involves more and more of the breast ; sometimes, 

 however, it is diffuse from the first, and sometimes it begins in the nipple. 



It may infiltrate the adjacent tissues and the axillary and cervical 

 glands, and form rnetastatic tumors in different parts of the body. l 



The local extension of carcinoma often takes place through the lymph - 

 vessels which pass along the fibrous trabeculse of the periglandular fat ; 



FIG. 468. ADENOMA OF THE MAMMA, 



These new-formed acini while maintaining the gland character are still quite atypical in form and grouping 

 and in the irregularity of the epithelium. 



so that bands of fibrous tissue harboring tumor cells, with their active 



1 For a study of dissemination of carcinoma of the breast see Stiles, Brit. Med. 

 Jour., vol. i., p. 1452, 1899. 





