乳 腺
1.Beware a lumpy area that does not feel right and images as normal.
—— Michael Dixon
【译文】小心那个感觉不对而各种影像正常的（乳房）质地不均匀区域。
2.A typical breast cancer is easy to diagnose——it is the atypical one in a young patient that causes diagnostic problems.
—— Michael Dixon
【译文】典型的乳腺癌容易诊断——难以诊断的是年轻患者的非典型病例。
3.The medical profession can invent test for breast diseases faster than they are found out to be useless.
—— David Dent
【译文】 医学界发明乳腺疾病诊断手段的速度快于其被证实无用的速度。
4.There is huge breast industry that feeds itself on the anxieties of breast cancer——prone women, and practices on scientific foundations which are no better than those which supported Halsted's radical mastectomy.
—— Moshe Schein
【译文】有一个靠消费乳腺癌易感女性的焦虑而生存的巨大产业，其赖以支撑的科学基础并不比那些支持Halsted乳房根治术的理由好多少。
【点评】正因为诸多不确定性才给了这些“巨大产业”生存空间。
5.The early period of the complaint is beyond all doubt the most favorable period for extirpating it … patients can be seldom convinced that there is any necessity for an operation while the disease continues in a mild state.
—— Henry Feardon, 18th century
【译文】毫无疑问，病情早期是根除它的最佳时期……但由于此时病情还维持在一个很轻的状态，患者很难相信有必要做手术。
6.At the same time it is clear that there is a stage in every case of carcinoma of the breast during which the disease is a local lesion and therefore any form of local treatment must depend for its success on early diagnosis.
—— Geoffrey Keynes, 1887——1982
【译文】同时，非常明确的是，每一例乳腺癌都有个时期，此时疾病尚属局部病变，因此任何形式的局部治疗的成功都有赖于早期诊断。
7.Even when a small portion of the breast is diseased, the whole mamma should be removed.The axillary glands should be dissected out by opening the armpit, but as much skin as possible should be preserved.I have done this since 1772 … The older surgeons took away the skin and left the glands.
—— Benjamin Bell, 1749——1806
【译文】即使乳房的一小部分发生病变，也应切除整个乳房，并切开腋窝清除腋窝淋巴结，但可保留尽可能多的皮肤。我从1772年就开始这样做了……老一辈的外科医生切除了皮肤却留下了腺体。
8.The cautery is used at first in order to prevent bleeding, but also because it helps to destroy the remains of the diseased tissues, When the burning is deep,prognosis is much better.Even in cases where indurated tumours of the breast occur that might be removed without danger of bleeding, it is better to use cautery,though the amputation of such a portion down to the healthy parts may suffice.
—— Aetius of Amida, 502——575
【译文】最初使用灼烙术是为了防止出血，但因为它有助于破坏病变组织的残留，当烧灼较深时，预后更好。即使对硬结性乳腺肿瘤也能在没有出血危险的情况下切除肿瘤。尽管切除范围到健康部分可能就足够了，但最好使用灼烙术。
【点评】真不敢想象那个年代用灼烙术做乳腺癌手术是一个什么样的场景。
9.The glands do not participate in the disease unless the system is strongly disposed to it and consequently their removal, however freely and effectually executed, cannot prevent the patient's relapse.
—— James Syme, 1799——1870
【译文】除非系统对它有强烈的易感性，否则这些淋巴结并不参与疾病的发生，因此，淋巴结的切除，无论多么肆意和有效地执行，都不能阻止患者的复发。
10.Why should we shave the under surface of the cancer … the pectoralis major muscle, entire or all except its clavicular portion, should be excised in every case of cancer of the breast.
—— William Stewart Halsted, 1852——1922
【译文】为什么我们要切除癌肿下面的……除了锁骨部分的所有或整块的胸大肌，并且每一个乳腺癌患者都这样做。
11.The surgeon who removes a breast with a malignant tumor should be the mortal enemy of the one who will be closing the wound.
—— William Stewart Halsted, 1852——1922
【译文】切除带有恶性肿瘤的乳房的外科医生应该是那个将要关闭伤口的医生的死敌。
【点评】难道大刀阔斧的切除者和关闭切口的不是同一个医生吗？(https://www.daowen.com)
12.I am not an experienced breast surgeon, but I have been interested in the aggressive therapy of cancer.I believe that our only hope is for the surgeon to be more aggressive … I submit that one of the weaknesses of the present so called Halsted operation is our inability to get cancer out of the brachial plexus.
—— Owen H.Wangensteen, 1898——1981
【译文】我不是一位有经验的乳腺外科医生，但却一直对癌症的侵略性切除有兴趣。我相信对外科医生而言唯一的希望就是更彻底切除……我认为，目前所谓的Halsted手术的缺憾之一是我们无法从臂丛神经中清除癌组织。
13.The female psychologically identifies with the breast, which represents her narcissistic and sexual reality and also her relationship with others and with culture.
—— Dominique Gross
【译文】从心理上而言，乳房等同于女性，她是女性自恋与性爱的象征性实体，也是她与其他人交往和文化内涵的标志。
14.Asya brought it (her breast) close it his face and held it for him."Kiss it!Kiss it!" She demanded … he nuzzled it with his lips like a sucking pig, gratefully,admiringly … its beauty flooded him … today it was a marvel.Tomorrow it would be in the trash bin.
—— Alexander Solzhenitsyn
【译文】 阿西娅捧起双乳贴近脸庞，不愿松手，“吻它! 吻它!” 她需要……好像吃奶的小猪一样用嘴唇蹭着它，感激地、痴迷地……融化在美丽中……今天它是如此让我爱不释手，明天却要被扔进垃圾桶。
15.The battle is between margins and cosmesis and we must think like the"oncoplastic" surgeon.
—— Marvin J.Silverstein
【译文】在安全边缘和美丽外观的“纠结”中我们必须得像个“肿瘤整形”外科医生。
16.I have drawn the impression that in dealing with mammary cancer surgery meets with more peculiar difficulties and uncertainties than with almost any other form of the disease.
—— James Ewing, 1866——1943
【译文】在我印象中，乳腺癌手术所遇到的特殊困难和不确定性几乎比任何其他疾病都要多。
【点评】自从有了精确的分子病理诊断和丰富、有效的非手术治疗措施后乳腺癌治疗的不确定性得到了大幅度的改善，“安全边缘与美丽外观的矛盾”也几乎不存在了。
17.I had initiated an important advance in practice by trying to eliminate what I regarded as surgical malpractice——the performance of a grossly mutilating and illogical operation, when similar or slightly better results could be obtained by conservative surgery supplemented by radiotherapy.
—— Geoffrey Keynes, 1887——1982
【译文】在实践中，我迈出了重要的一步，试图消除这个手术的弊端——严重残缺和不合逻辑的手术，通过保守手术加上放疗可以获得相似或稍好的结果。
【点评】这是乳腺癌现代治疗的第一个重要转折点。
18.The main the desideratum in the treatment of carcinoma of the breast as in other forms of cancer remains the discovery of some agent which will deal with the deposits outside the field of local treatment.
—— David H.Patey, 1899——1977
【译文】治疗乳腺癌和其他癌症一样，最迫切的依然是找到一些能够处理局部治疗之外残留肿瘤的药物。
19.Breast cancer is a heterogenous, systemic disease involving a complexity of host-tumor inter-relationship; variations in local-regional therapy are unlikely to affect survival substantially.
—— Bernard Fisher, 1918——2019
【译文】 乳腺癌是一种非均质化的全身性疾病，机体与肿瘤相互关系复杂，五花八门的局部或区域治疗难以从实质上影响患者的生存。
【点评】伯纳德·费舍尔（Bernard Fisher）是美国著名外科医生和科学家，正是他通过研究证明了破坏外观的标准乳腺癌根治术常常是不必要的，并提出化疗和激素治疗可以延长生命，从而彻底改变了乳腺癌的标准治疗。
20.All of these patients, younger as well as older, whether they have tumors that have estrogen receptors or tumors that do not, they all show a benefit when you add chemotherapy.
—— Bernard Fisher, 1918——2019
【译文】所有这些患者，无论是年轻的还是年老的，无论他们的肿瘤是否有雌激素受体，当你加入化疗时，他们都显示获益。
【点评】终于找到了处理残留肿瘤的化疗和内分泌治疗方法。
21.The use of tamoxifen can prevent breast cancer in patients who have no evidence of breast cancer but are at high risk of getting it.
—— Bernard Fisher, 1918——2019
【译文】使用他莫昔芬可以预防那些没有乳腺癌迹象但有乳腺癌高危因素者患乳腺癌。
【点评】这也是Bernard Fisher的重要贡献。