Frederick Childe Hassam
"Lady in Flower Garden"
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Concentrate all your thoughts upon the work at hand.
The sun's rays do not burn until brought to a focus.
A 40-year-old female Ms. Sun Shine,
an avid gardener, presents to your office after she noticed a blue-red mass under her right breast
(lower outer quadrant). She describes the mass as painless, non-tender, firm but does not itch.
She denies any nipple discharge. She says she first noticed the mass two days ago but does not
know how long it has been present since it is in a difficult location to see and she lives alone.
She does not report any other symptoms.
She is not currently taking any medications, but is allergic to sulfa drugs.
Past surgical history includes tonsillectomy as child, breast biopsy, followed by lumpectomy
for Ductal Carcinoma in Situ, diagnosed 8 years prior to this office visit. She received post
lumpectomy radiation. Has never had lymph edema in her arm or the local area around the lumpectomy scar.
Vitals: T 98.6 R 13 P 67 BP 129/85.
On physical exam her heart has a RRR without murmurs.
Her lungs are CTAB (clear to auscultation bilaterally)
without wheezes, crackles or rales and no areas dullness on percussion.
The mass is a moderately well demarcated plaque lesion and measures approximately
5.0 x 3.0 cm on the skin surface.
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