CHIEF COMPLAINT: 

PRESENT ILLNESS: Ms. [**Known lastname **] is a 42-year-old
woman who was found to have a right breast abnormality on a
core breast biopsy on [**2111-3-17**] following an abnormal
mammogram. Pathologic review of that specimen showed it to be
infiltrating ductal carcinoma with grade III necrosis. Tumor
cells were noted to be negative for estrogen and progesterone
and were positive for Herceptin overexpression. The patient
does have a prior history of right breast cancer in [**2107**], at
which time a 1-cm mass was removed. She was node negative.
Following that, she [**Year (4 digits) 1834**] both chemo and radiation
therapy.

MEDICAL HISTORY: None other than the above.

MEDICATION ON ADMISSION: 

ALLERGIES: MORPHINE.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Malignant neoplasm of upper-outer quadrant of female breast,Acquired absence of breast and nipple,Depressive disorder, not elsewhere classified
Mal neo breast up-outer,Acq absnce breast/nipple,Depressive disorder NEC
Admission Date: [**2111-5-4**]        Discharge Date: [**2111-5-8**]

Date of Birth:  [**2068-7-21**]        Sex:  F

Service:  [**Last Name (un) **]


ADMISSION DIAGNOSIS:  A 42-year old female with right breast
cancer proven by core biopsy.

PROCEDURE:  Right modified radical mastectomy with
reconstruction.

HISTORY OF PRESENT ILLNESS:  Ms. [**Known lastname **] is a 42-year-old
woman who was found to have a right breast abnormality on a
core breast biopsy on [**2111-3-17**] following an abnormal
mammogram. Pathologic review of that specimen showed it to be
infiltrating ductal carcinoma with grade III necrosis. Tumor
cells were noted to be negative for estrogen and progesterone
and were positive for Herceptin overexpression. The patient
does have a prior history of right breast cancer in [**2107**], at
which time a 1-cm mass was removed. She was node negative.
Following that, she [**Year (4 digits) 1834**] both chemo and radiation
therapy.

PAST MEDICAL/SURGICAL HISTORY:  The patient has had a left
ATL repair.

PAST MEDICAL HISTORY:  None other than the above.

MEDICATIONS:  Ativan 0.5 mg p.r.n., Effexor 75 mg daily.

ALLERGIES:  MORPHINE.

PHYSICAL EXAMINATION UPON PRESENTATION:  The patient was
described as a healthy-appearing Caucasian female in no acute
distress. Her temperature was 98.8, blood pressure was
102/67, pulse was 63, height of 5 feet 5 inches, weight of
178. Pupils were equal and reactive to light. Cranial nerves
II through XII were intact. The lungs were clear to
auscultation bilaterally. Cardiac examination was
unremarkable. Right breast showed a prior incision, well
healed.

BRIEF HOSPITAL COURSE:  On [**2111-5-4**] Ms. [**Known lastname **]
[**Last Name (Titles) 1834**] a right modified radical mastectomy of her right
breast. This was followed by a plastic surgery breast
reconstruction with a SIEA technique. The patient also
[**Last Name (Titles) 1834**] a left breast reduction. The patient reportedly
tolerated the procedure very well and was taken to the post
anesthesia care area. There, here temperature was 100. Pain
was well controlled with p.r.n. morphine. The first night
following the operation, postoperative day 1, was spent in
the intensive care unit for every 15-minute flap appraisals.
Throughout this period the flap appeared healthy with both
normal capillary refill and dopplerable arterial and venous
signals. On postoperative day 2, the patient was in a normal
floor room. She was tolerating a regular diet, and analgesia
was ultimately converted to oral medication. The following
day, after a final evaluation of her flap by the plastic
surgery team, it was felt that there had been a shift in the
Doppler signal from her flap pedicle. Given this change in
her exam it was felt necessary to hold her overnight for an
additional night of observation. The following morning the
flap was once again noted to be pink and healthy appearing
with good capillary refill and no signs of any venous
congestion or necrosis. After final examination by the
attending plastic surgeon and attending breast surgeon, it
was deemed that the patient was a good candidate for
discharge.

DISCHARGE FOLLOWUP:  The patient will follow up with Dr.
[**Last Name (STitle) 11635**] in 1 to 2 weeks. The patient will also follow up
with Dr. [**First Name (STitle) **] in 1 to 2 weeks.

DISCHARGE DISPOSITION:  The patient was discharged to home in
the care of her family.

CONDITION ON DISCHARGE:  The patient is in stable condition.
She leaves with 2 drains in place. She has been trained on
how to empty those drains and record the output. These will
be assessed for possible removal at her first follow-up visit
with Dr. [**First Name (STitle) **].

MEDICATIONS ON DISCHARGE:  The patient is discharged on all
of her home medications in addition to aspirin 162 mg p.o.
daily, Percocet 1 to 2 tablets q.4-6h. p.r.n., Keflex 500 mg
p.o. q.6h., and Colace 100 mg p.o. b.i.d. while taking
narcotics.



                        [**Name6 (MD) 17486**] [**Name8 (MD) 11635**], [**MD Number(1) 18026**]

Dictated By:[**Last Name (NamePattern1) 9178**]
MEDQUIST36
D:  [**2111-5-8**] 10:23:06
T:  [**2111-5-8**] 11:31:44
Job#:  [**Job Number 35802**]
{'Malignant neoplasm of upper-outer quadrant of female breast,Acquired absence of breast and nipple,Depressive disorder, not elsewhere classified'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: Ms. [**Known lastname **] is a 42-year-old
woman who was found to have a right breast abnormality on a
core breast biopsy on [**2111-3-17**] following an abnormal
mammogram. Pathologic review of that specimen showed it to be
infiltrating ductal carcinoma with grade III necrosis. Tumor
cells were noted to be negative for estrogen and progesterone
and were positive for Herceptin overexpression. The patient
does have a prior history of right breast cancer in [**2107**], at
which time a 1-cm mass was removed. She was node negative.
Following that, she [**Year (4 digits) 1834**] both chemo and radiation
therapy.

MEDICAL HISTORY: None other than the above.

MEDICATION ON ADMISSION: 

ALLERGIES: MORPHINE.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Malignant neoplasm of upper-outer quadrant of female breast,Acquired absence of breast and nipple,Depressive disorder, not elsewhere classified'}
