# data[].attributes.body
1. 49 YEARS-OLD WOMAN

2. Presented with a lump in her left breast

1. Common causes of breast lump

1. Cancer

2. Cysts

3. Fibroadenoma

4. Fibrocystic changes

5. Coming of period

6. Mastitis (although not a common cause, requires signs of infections e.g. fever)

7. Traumatic fat necrosis (inflammation can manifest as lump)

# data[].attributes.body
1. Presence of pain - X

2. Period pain (lump comes during periods) - X

3. Presence of nipple discharge - X

4. Redness, bleeding? - X

5. Invasion of the nipple (peau d'orange)

6. Skin changes - X

7. Any weight loss? - X

8. When menarche? (Before age of 10) - /

9. Late pregnancy - X

10. History of breastfeeding (increase chances of breast cancer) - X

11. Past medical history

1. History of trauma? - X

2. Any past infections - X

3. Menstrual history (menopause or not) - X

4. Medications - X

12. Family history

1. Familial history of breast cancer - /

13. Social history

1. Alcohol - /

2. Smoking - /

3. Occupation (socioeconomic status)

1. Exposure to contaminants - X

2. Radioactive - X

3. High-stress environment - /

# data[].attributes.body
1. Cancer

2. Cysts

3. Fibroadenoma

4. Fibrocystic changes

5. Coming of period

6. Mastitis (although not a common cause, requires signs of infections e.g. fever)

7. Traumatic fat necrosis (inflammation can manifest as lump)

# data[].attributes.body
1. Upper outer quadrant of the left breast (most common, cancer more common in the left breast > right)

2. No nipple discharge, skin changes or alteration in the lump's size (symptoms of malignancy)

3. History of fibrocystic diseases

4. Familial history (BRCA1, BRCA2 genes)

5. No radiation exposure

6. Premenopausal

7. Menarche before age of 10 (increase exposure to estrogen, progesterone and HER2 receptors increased exposure)

8. Patient mother died at age of 45 from breast disease (first degree relative, (BRCA1, BRCA2 genes) plays a critical role in DNA repair)

9. No contraceptives - no family planning

10. Moderate smoking and alcohol - increased risk for carcinoma

11. Lawyer - high socioeconomic status - high educated women are high risk of cancer. (disputed claim)

# data[].attributes.body
1. Cancer

2. Cysts

3. Fibroadenoma

4. Fibrocystic changes (Coming of period)

5. Mastitis (although not a common cause, requires signs of infections e.g. fever)

6. Traumatic fat necrosis (inflammation can manifest as lump)

# data[].attributes.body
1. anxious

concern about cancer

2. 2cm mass non tender slightly moveable

indicate malignant - mobile ,fix to soft tissue

3. several smaller nodules and ill-defined firm areas were present in both breasts

fibrocystic changes

metastasis

4. The nipple and skin appeared normal.

early stage

easy to detect on early stage

5. 1.5cm moveable nodule left axilla

5 group for axillary nodes

location

might need lymph node biopsy

axillary clearance

# data[].attributes.body
1. Cancer

2. Cysts

3. Fibroadenoma

4. Fibrocystic changes (Coming of period)

# data[].attributes.body
1. maging studies: A mammogram and ultrasound showed a 25mm irregular mass with stippled calcifications in the upper outer quadrant of the left breast.

malignant lesions

2. A core biopsy revealed moderately differentiated invasive ductal carcinoma.

1. lumpectomy of the left breast with sentinel lymph node

evaluation

-

1. Gross examination of the lumpectomy specimen showed a 20 mm,grey, scirrhous mass in the central portion of the specimen.The margins of the

lumpectomy specimen were free of a tumour.

2. Histopathology of the sentinel lymph node revealed metastatic ductal carcinoma

3. showing two additional positive lymph nodes out of 15

4. tumour to be oestrogen and progesterone receptors positive with a high proliferative rate and a diploid DNA content.

5. tumour was HER2 positive.

for breast cancer

1. Adjuvant therapy. The patient was given chemotherapy, radiotherapy and immunotherapy.