A 41-year-old woman comes to the physician for a lump in her right breast. Physical examination shows dimpling of skin of the breast over the mass. A CT scan of the breast shows a 3-cm mass at the right upper quadrant of her right breast with multiple calcifications. The dimpling of the breast is most likely caused by invasion of the tumor into which of the following structure(s)?

The 35-year-old woman comes to the physician because of a breast lump that she noticed 1 month ago on self-breast examination. Physical examination shows a 1 cm hard nodule located just above and lateral to the areola of her right breast. A radioactive dye is injected into the tissue around the tumor, and an incision is made to expose the lymphatic vessels draining the area. Which of the following groups of lymph nodes will be first to receive the dye from the tumor? 

A 47-year-old woman comes to the physician because of a 3-month history of skin changes of her right breast. Physical examination shows warmth, erythema, and skin dimpling (peau d’orange) of the right breast. A mammogram shows suspicious findings of breast cancer and a full-thickness skin biopsy is performed to confirm the diagnosis. This condition is primarily the result of which of the following?

A 52-year-old woman underwent mastectomy for invasive ductal carcinoma of the left breast. During the procedure the tumor and the pectoral, central axillary, and apical axillary lymph node groups were excised. Six months later she comes to the physician for a follow-up examination. Physical examination shows a deep, hollow area inferior to the medial half of the clavicle. The patient has no motor or sensory deficits. Which of the following is the most likely cause of the findings on physical examination?

A 26 year old woman presents with severe back pain. Her breasts are noted to be large and pendulous without lumps or nipple discharge. The physician suggests reduction mammoplasty. Which condition does this patient suffer from?

A 23 year old woman presents with a 1 cm mass on her left breast. The mass is firm, painless, and freely movable. Since discovering the mass, the patient has not noticed a change in its size. A histological examination of the mass reveals layers of ductal cells with dense stroma. Which of the following is the most likely diagnosis?

A 48 year old woman presents for evaluation of a small mass next to her right nipple. She has also noticed a small amount of discharge over the past week. On physical exam, you palpate a 1 cm round nodule beneath the areola and notice some clear discharge. Breast examination is otherwise normal and no lymph nodes are palpable. A lesion biopsy reveals intraductal papilloma without atypia or malignant cells. Which of the following is true regarding this lesion?

The 35-year-old woman comes to the physician because of a breast lump that she noticed 1 month ago on self-breast examination. Physical examination shows a 1 cm hard nodule located just above and lateral to the areola of her right breast. A radioactive dye is injected into the tissue around the tumor, and an incision is made to expose the lymphatic vessels draining the area. Which of the following groups of lymph nodes will be first to receive the dye from the tumor?

A 42-year-old woman comes to the physician because of 10-day history of dysesthesia in the inner aspect of the arm and axilla. She had a total mastectomy including excision of the axillary tail (of Spence) after being diagnosed with carcinoma of the breast two weeks ago. Vital signs are within normal limits. Which of the following nerves was most likely injured during the procedure? 

A 42-year-old man comes to the physician for abdominal pain. He is diagnosed with liver and pancreatic disease as a result of alcoholism. Physical examination shows an enlargement of his mammary glands, as a secondary result of his disease process. Which of the following clinical conditions will most likely describe this case?