Snapshot A 46-year-old woman presents to her primary care physician after discovering a lump in her left breast. She denies any breast pain or nipple discharge. Physical exam reveals a 2 cm firm, fixed mass in the left breast in the upper outer quadrant with no axillary lymphadenopathy. Introduction Overview login to view 3 more bullets Epidemiology Incidence login to view 5 more bullets Risk factors login to view 24 more bullets Prevention login to view 4 more bullets ETIOLOGY Genetics login to view 1 more bullet Classification Benign breast tumors login to view 2 more bullets Carcinoma in situ login to view 10 more bullets Invasive carcinoma login to view 6 more bullets Presentation History login to view 2 more bullets Symptoms login to view 4 more bullets Physical exam login to view 9 more bullets Imaging Mammography login to view 20 more bullets Magnetic resonance imaging (MRI) login to view 6 more bullets Ultrasound login to view 4 more bullets Tumor, Node, Metastasis (TNM) Staging Staging is done with the TNM system and imaging (CT/bone scan) Most important prognostic factor TNM Staging Nodes None Mobile Axillary Fixed Axillary Distant Mets Size > 5 cm Stage IIB Stage IIIA Stage IIIA Stage IV 2-5 cm Stage IIA Stage IIB Stage IIIA Stage IV < 2 cm Stage I Stage IIA Stage IIIA Stage IV Studies Serum calcium level login to view 1 more bullet Alkaline phosphatase login to view 1 more bullet Hormone receptor tests login to view 3 more bullets Differential Benign breast mass login to view 7 more bullets Other cancer login to view 3 more bullets Treatment Medical login to view 15 more bullets Surgical login to view 18 more bullets Prognosis Dependent on stage and type login to view 1 more bullet 40,000 deaths per year