General examination

You notice Mavis seems slightly pale, but otherwise looks well.

Her chest sounds clear and abdomen is non-tender with no palpable masses.

You ask her whether she has had a screening mammogram recently, and she tells you she has been too scared to attend. She consents to a breast examination. You find an irregular mass in the upper outer quadrant of her left breast. This seems to be attached to the skin with some peau d'orange changes but not attached to the chest wall. You wonder if she may have a small palpable lymph node in her left axilla.