1. CASE PRESENTATION OF BREAST CARCINOMA

2. CASE HISTORY NAME- Aarti AGE- 50 yrs SEX- Female ADDRESS- Mahendergarh
RELIGION- Hindu
MARITAL STATUS- Married
OCCUPATION- Housewife
CHIEF COMPLAINTS- Lump in rt breast for 3 months

3. HISTORY OF PRESENT ILLNESS
Pt. was apparently asymptomatic 3 mnts back when she first noticed a lump in rt breast
LUMP-
Upper outer quadrant
Insidious in onset
Gradually progressive (initially of size of lemon and increased to the size of orange)
Ass. with bloody discharge
Recent retraction of nipples
Not ass. with pain,itching and vesicle formation
7. No aggravating and relieving factors
8. H/O wt. loss , decreased apetite
9. No H/O fever
10. No H/O bone pain , difficulty in breathing, chr. cough, chest pain, abd. Pain
11. No H/O radiation exposure.
12. No H/O other lump in same or other breast

4. PAST HISTORY
No H/O similar complaints in the past on the same side or on other side
No H/O trauma, previous surgery
No H/O TB, DM, Epilepsy, HTN

5. PERSONAL HISTORY Non smoker Non alcoholic Non vegetarian
MENSTRUAL HISTORY- Menopause 3 yrs back

6. FAMILY HISTORY
No H/O similar complaint in the family- specially in mother or first generation relative
No H/O ovarian or endometrial CA in mother or sibling

7. GENERAL PHYSICAL EXAMINATION
Pt. is conscious, cooperative, well oriented to time, place and person and lying comfortably in the bed
Pt. has –
Pulse= 96/ min
RR= 18/min
BP= 120/90 mm Hg
Temp. = 98.8*F
On GPE-
No pallor
No icterus
No cyanosis
No pedal odema
No clubbing
Lymphadenopathy +nt

8. LOCAL EXAMINATION
Pt. is examined in sitting position in well illuminated room
On Inspection-
RT BREAST-
Rt breast distorted in shape and comparatively larger than lt
Orange peel appearance
No ulceration, fungation, scar mark
No dilated veins
Visible lump seen in rt breast in upper outer quadrant at 10’o clock position
LT BREAST-
No visible lump seen
NIPPLE-
Not symmetrical
Rt nipple placed higher than lt
Retraction of rt nipple seen
Bloody discharge seen

9. AREOLA-
No cracks, fissures, swellings seen
ARM-
No odema seen
On Palpation-
LT BREAST- No mass palpable
RT BREAST-
Temp –Normal
No tenderness
LUMP-
+nt in upper outer quadrant at 10’o clock position, reaching to upper inner quadrant and +nt upto nipple
Size- 10*8 cms
Hard consistency
Uneven surface
Regular margins
Fluctuation test –ve
On trans illumination test appears opaque
Fixity to breast tissue, skin
Adherent to nipple
Bloody discharge from nipple

10. LYMPH NODE EXAMINATION
Carried out in sitting position
Pectoral gp of lymph nodes-
are enlarged
single in no.
located along antr axillary fold
hard consistency
matted
mobile
no skin changes
no scar mark
no odema of arm
No other gp of lymph nodes are palpated

11. PROBABLE DIAGNOSIS BREAST CARCINOMA DIFFERENTIAL DIAGNOSIS-
Giant Fibroadenoma
Breast cyst
Paget’s disease

12. DISCUSSION
A 50 yrs old female , married, with two children came in the OPD with a chief complaint of lump in rt breast for 3 mnts which was insidious in onset, progressively increasing in size with no pain and H/O significant wt. loss and bloody discharge, no +ve family history, on examination a solitary lump of size 10*8cm is +nt in upper outer quadrant, reaching to upper inner quadrant +nt upto nipple having hard consistency, irregular margins, uneven surface, fixating to breast muscle and pectoral muscles with axillary lymph node enlargement.
The probable diagnosis is breast carcinoma

13. THANK YOU