Joan Barker, age fifty-six years, comes for a routine physical examination. She states that she has been in perfect health and has no complaints. She has a history of asthma but currently requires no medications of any kind. Her physical examination is completely normal, except for a 2-cm firm, nontender, nonmobile mass in the upper outer quadrant of her left breast. She indicates that she does not perform regular breast self-examination and that she did not know the mass was there. She has no family history of breast cancer and has never been pregnant.
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