55 year old man presented at the breast clinic of KATH , Kumasi with one year duration of painless right breast  mass. The mass has been slowly but progressively increasing in size over the period.  He has no other constitutional symptoms and only came to hospital as a result of failed  traditional local therapy. It bleeds occasionally as a result of topical herbal agents applied. He   drinks and smokes but responded in the negative for other  risk  factors . He has no other complications associated with presentation
Examination : Generally well, 4x3x2 cm fungating mass protruding from right nipple areolar region in upper outer quadrant of right breast . Firm nodular mass, completely deforming nipple areolar complex, edges well defined , non tender,  fixed to skin but mobile over chest wall . Three ipsilateral axillary lymph nodes measuring 2x1cm palpated , two matted together , one mobile. Single lymph node found in the ipsilateral supraclavicular region. All other systems normal
Diagnosis : locally advanced Right breast cancer
Clinical stage T4b N3 Mx
Investigations
1. Core needle biopsy of mass for histopathology
2. CXR, Abdominal CT scan
3. Breast USG
4. FBC, LFT, RFT, serum Ca
Treatment :
Awaiting updates on this case
Credits: Dr Richard Ametih, KATH,  Kumasi