A 48-year-old Japanese woman presented with a 6-month history of increasing exertional dyspnea and dry cough. She denied fever, night sweats, or weight loss. She was a nonsmoker. Her medical history was unremarkable except for the fact that she had been aware of a mass in her left breast for >2 years.On admission, her temperature was 36.7 deg C, her pulse was regular at 70 b.p.m., and her respiratory rate was 16 breaths/min. Her lungs were clear on auscultation, and cardiac examination revealed no murmur or gallops. No edema or varicosities were seen in her lower extremities. A hard mass measuring up to 3 cm in diameter was palpable in her left breast.
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