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PAST MEDICAL HISTORY: Breast cancer (status post lumpectomy and radiation) and hyperlipidemia.

MEDICATIONS: Aspirin, Arimidex, Lipitor, and Fosamax.

FAMILY HISTORY: The patient’s sister with colon cancer as above; no other family history of GI malignancies, inflammatory bowel disease, or peptic ulcer disease.

REVIEW OF SYSTEMS: No nausea, vomiting, abdominal pain, fevers, chills, melena, bright red blood per rectum, constipation, diarrhea, weight loss or loss of appetite.

PHYSICAL EXAMINATION:
Vital signs: Blood pressure is 140/90. Pulse is 68 per minute. Respiratory rate is 16.
General: This is a well-developed, well-nourished female in no acute distress.
HEENT: Normocephalic, atraumatic and anicteric.
Neck: No jugular venous distension. No carotid bruits.
Lungs: Clear to auscultation and percussion.
Heart: Regular rate and rhythm. No gallops, rubs or murmurs.
Abdomen: Soft and nontender; bowel sounds are present. A well‑delineated periumbilical mass is felt. Old lower abdominal scar is noted.
Skin: Good turgor.
Extremities: Without clubbing or edema.
Nodes: No cervical or axillary adenopathy is appreciated.
Neurologic: The patient is alert and oriented to person, place and time. No cogwheeling or resting tremor is noted.