The operability of a carcinoma of the breast depends on many factors, chiefly, however, on the extent of the pathologic condition. It is true that many varieties of carcinoma exist as far as the malignancy and progress of the lesion are concerned. Some grow slowly, some rapidly, some form their metastatic deposits very gradually, others show from the start a quick dissemination. On the whole, however, the progress is similar in all, namely, first an invasion of the regionary axillary glands, then of the glands of the supraclavicular region of the same side, then of the chest and sometimes of distant portions of the body.
Experience shows that recurrence of the growth after a skilful radical excision is mostly seen in the axillary region and in the neck, whereupon the vessels, particularly the veins and the nerves of the arm, become blocked and compressed. The neuralgic pains of the arm