Bilateral Mammogram:

There were four 1.0,-1.5 cm masses diffusely distributed throughout the Left Breast and three 0.5-1.0 cm masses in the right breast. There were also a 2.3 cmx 2.9 cmx3.2 cm mass with irregular boarders within the upper outer quadrant of the right breast. Associated with the suspicious lesion was diffuse skin thickening and an enlarged axillary lymph node of approximately 2.0 cm in greatest dimensions. Six Y- shaped microcalcifications that extended toward the nipple were seen. There is some evidence of extension of the abnormal mass into pectoral muscle.

Ultrasound Right Breast and right axilla:

Three 0.5-1.0 cm cystic lesion diffusely distributed throughout the breast

Solid-appearing, non-cystic mass consistent with cancer in upper outer quadrant

Ill-defined mass with abnormal vascularity

The mass measures 2.3cm x 2.9 cm x 3.2 cm

There is some suggestion of skin thickening and mild tissue edema

Core-Needle Biopsy:

Pathology was consistent with that of infiltrating breast carcinoma

Tubules were observed in 80-90% of the sample

Approximately 3-5 cell divisions were seen per high-power field and there was only a mild degree of pleomorphism

The tumor was positive for both estrogen and progesterone receptors

Ultrasound of Liver:

NO masses suggesting metastasis were observed
A 0.5 cmx 0.6cm faintly visible region was observed to the left side and slightly cephaled of the ligamentum venosum.The appearance of the lesion is more consistent with that of a hemangioma than with a metastasis nodule

Bone Scan:

No definite evidence of bone metastasis.
Positive for mild degenerative changes of lumbar spine

Clinical Course:

The breast surgeon provided 2 treatment options.

1. Lumpectomy with sentinel node biopsy, followed by breast irradiation.
2. Modified radical mastectomy with sentinel node biopsy without or with reconstruction.

The patient elected breast conservation and sentinel lymph node biopsy with radiation therapy. The sentinel nodes were negative and all surgical margins were clear. The patient was treated with radiation.

QUESTION:

1. Based on the clinical information available to this point to which GRADE has this patient‘s cancer progressed?

2. Based on the GRADE of the cancerous mass, what is this patients expected 10-year survival rate?

3. Identify the stage to which this patients breast cancer has advanced.

NOTE:

Prepare 300 words for each question.  I Need minimum 3 references.