A 62-year-old female presents with a singular, hard, 1 cm, nontender, nonmobile mass in the right breast. There are no nipple or skin changes, however, you palpate an enlarged right-sided supraclavicular lymph node. The clinician should recognize these are signs of:

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A hard, nonmobile mass in the breast, especially when associated with enlarged supraclavicular lymph nodes, is highly suggestive of malignancy. Fibroadenomas are usually mobile and not associated with lymph node enlargement, breast cysts are typically tender and fluid-filled, and Paget's disease of the breast presents with nipple changes.

A 62-Year-Old Female Presents with a Singular, Hard, 1 Cm