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A review of historical literature shows that Spence himself never wrote that adipose or breast-tissue extends into the axilla. He only published that surgeons should not operate on breast cancer if they found “an undefined tail-like projection creeping up from the breast towards the axilla”, as though referring to the tumor tissue itself. Spence’s peers interpreted his remarks and published with differing descriptions, blurring anatomic understanding. Since 1871, a notion evolved of a tail-like extension of fatty tissue originating from the upper outer portion of the breast and traveling into the axilla. Over the next 150 years, the concept became engrained in medical parlance and literature, even though there has never been a detailed anatomic description or published anatomic data to support the anecdotal mention made by Spence and described in various ways by other authors.

Did she do something to her face? Her lips especially look off.