Tag Archives: breast

Peau d’Orange

Peau d’orange is the dimpling of the skin that resembles the skin of an orange. It is usually seen in advanced breast cancer where there is stromal infiltration and lymphatic obstruction. (from earthwidesurgicalfoundation.blogspot)

Image source: earthwidesurgicalfoundation.blogspot

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Radiation Therapy

Georges Chicotot; a physician with credentials in both painting and Roentgenology.  In 1910, he painted a self portrait that documents a historic moment in radiotherapy: the first attempt to treat breast cancer with X-rays. In his left hand he holds a watch to time the exposure, in his right he holds a sort of extended Bunsen burner that spouts flames from its tip. He is heating the vessel that warms the vacuum tube. And that object glowing from the center of this painting? Well, it’s a Crookes tube. (link to source)

Georges Chicotot (active ca. 1889 – 1907).  The First Attempt to Treat Cancer with X-Rays, 1907.  Musée de l’Assistance Publique, Hopitaux de Paris (source link) (additional source link)

The picture can be read on several levels, but the scene is unequivocal.  Dr. Georges Chicotot, head of radiotherapy at the Hôpital Broca, shows himself treating cancer with X-rays.  In his left hand he holds a watch to time the exposure; in his right he hold a sort of extended Bunsen burner that spouts flame from its tip.  He is heating the vessel that holds the generator, the Crookes tube.  The X-rays are focused on the patient’s breast by a glass cylinder.  The ominous electrical apparatus on the mantelpiece is simply a transformer, and the two vacuum valves on either side of the tube regulate the current.  The Crookes tube and its enclosing vessel are painted in earie green, yellow, and orange.  The woman, who is either sedated or oblivious, is undressed.  Her corset and dress are shown on a stool at the left.  She is no jeune fille; a wedding ring is shown on her right ring finger.  All of the composition lignte of the complex painting lead to her right breast; she is a beautiful woman with a fatal disease.  Chicotot does not look at her- his eyes are on the watch- but the tube in his right hand is aflame.  He wears a top hat and huge apron, perhaps because- to quote a description of this work from the Presse Médicale of 1932- “all doctors of the time were recognizable in their laboratory by their top hat [chapeau haut de forme] and white apron.”

This picture must be the only one in the history of experimental medicine in which the doctor produced not only data but art! Chicotot was what the French call bicéphale; he was a doctor with two heads.  In the land where the forma of a hat follows the function of the wearer, he was entitled to two.  An honored graduate of the École des BeauxArts, he won several medals for historical paintings which he exhibited at the annual Salons.  His paintings were highly finished and based on an extraordinary interest in anatomy, which he had taught as a prosector in the School of Practical Anatomy.

Darwin’s Audubon: Science and the Liberal imagination (the Doctor with Two Heads) p. 220

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Peau d’orange

The French term peau d’ orange means “orange peel skin”, or more literally “skin of an orange”. Classically is is seen in advanced inflammatory breast cancer, but can be seen in other conditions.

The suspensory ligaments of Cooper play an important role in the change in appearance of the breast that often accompanies the development ofinflammatory carcinoma of the breast in which blockage of the local lymphatic ducts causes swelling of the breast. Because the skin remains tethered by the suspensory ligaments of Cooper, it takes on a dimpled appearance reminiscent of the peel of an orange (peau d’orange). Carcinomas can also decrease the length of Cooper’s ligaments leading to a dimpling. (from wikipedia)

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