A 32 yr old female came to the surgery opd for a lump in the left breast since 6 months and restriction of movement of the left hand d/t oedema since 3 months. Patient was a/a 6 months back when she noticed a small peanut sized swelling in the breast which then grew to the size of 7×8cm within 6 months. The swelling is also associated with pain, tenderness.
There is history of nipped retraction of left breast
No H/o discharge from the nipple
h/o significant weight loss and loss of appetite
She got married at the age of 13y. Menarche at the age of 14 and birth of the 1st child at the age of 14 who was breast fed for 1 n half year.
H/o some previous surgery who's details are not known.
H/o amenorrhoea since the age of 17
Family history insignificant.
Right breast appears to be normal
Left breast shows retraction of nipple, peau de Orange, dumpling of skin over the swelling
Central group of lymph nodes are enlarged.
Swelling not adhered to the chest wall but adhered to the breast tissue.
What is the diagnosis +/- staging and what could be the apparent etiology? Treatment and prognosis?