Breast Lump

Sir, my patient is a middle age lady who appears to be well. She is not cachexic.
On inspection of both breast, with various position like raising hands above head
and pressing against her hip and leaning forward, both breast are symmetrical in
size and shape. There is no obvious lump seen, no overlying skin changes
(dimpling, pleu de orange, erythema, scars), both nipple areolar complex (7 Ds)
are normal. Both arms appear to be normal.
On palpation, there is no raised temperature and tenderness. There is a lump
located at the left upper outer breast, measuring 3x2cm, non tender, firm in
consistency, smooth surface, well-defined margin, very mobile, not attached to
the skin or underlying structures. No other lump was felt. No nipple discharge.
There are no axillary or cervical lymph nodes (supraclavicular) felt.
To complete my examination, I would like to examine the abdomen for
hepatomegaly and also ovarian metastasis (Krukenbergs tumour), spine, skull
and long bones for bony tenderness (spine) and auscultate the lungs for
evidence of pleural effusion.
In summary, she is likely to have fibroadenoma of the left breast in view of the
patient general condition, age, and the lump features.
I would like to evaluate the lump via the triple assessment (Clinical examination,
Imaging, Histology).
Inguinal Hernia
On local examination of inguinoscrotal region,
On inspection, there is a pyriform shape swelling in right inguinoscrotal region
extending from the right inguinal region extending from the right inguinal canal
to the bottom of scrotum.
On palpation, it lies above & medial to pubic tubercle
temperature is normal and there is no tenderness over the swelling.
It is not possible to get above the swelling and there is palpable cough impulse
over the swelling.
The swelling is soft.
On lying down, swelling is spontaneously/manually reducible
Deep ring occlusion test is positibve.
On percussion, the swelling is resonant
On auscultation, bowel sounds are audle
The left inguinoscrotal region is normal and the systemic examination is also
normal.