Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: past medical history: 1. breast cancer, metastatic to liver, bone, diagnosed in , status post lumpectomy and xrt with one node positive, therapy finished in . in , noticed limping in the left hip. a new lesion was found as well as a question of a right rib lesion. she was started on pamidronate at that time. in , she was given tamoxifen times nine months and then changed to arimidex due to an increasing ca27-29. at that time, she also started megace briefly. she was then changed to exemestane. in , the patient was started on navelbine, received six cycles through . in , the patient started taxol and received four cycles until . in , the patient was started on fasoodex. in , the patient was started on gemcitabine for which she is on her second cycle. 2. hyperlipidemia. 3. status post cesarean section. allergies: the patient has no known drug allergies. admission medications: 1. multivitamin. 2. lipitor. 3. advil. family history: negative for cancer. social history: the patient is married. the patient's husband, , cell phone and pager , is involved in her care as is her daughter. the patient denied any history of alcohol, smoking, or drug use. physical examination on admission: in general, the patient was a frail woman in no acute distress. vital signs: 98.1, 120, 110/69, 16, 99%. heent: the mucous membranes were dry. the neck veins were flat. cv: tachycardia, regular, no murmurs, rubs, or gallops. chest: clear to auscultation bilaterally. abdomen: soft, nontender. the liver was several centimeters below the costal angle. extremities: no clubbing, cyanosis or edema. laboratory data: wbc 3.1, hematocrit 19.2, platelets 126,000. alt 130, ast 604, alkaline phosphatase 508, total bilirubin 3.1. hospital course: 1. hematology: the patient was admitted for anemia and transfused 3 units of blood in the ed. she was also noted to be in low-grade dic with slightly elevated d-dimer, low fibrinogen. she was transfused 2 units of ffp. she had inadequate hematocrit increase with this and received an additional 2 units for a total of 5 units of packed red blood cells. the patient's blood counts remained stable through the rest of her admission. she needs to have this followed as an outpatient. the cause of her dic is likely her metastatic cancer. this will also need to be followed as an outpatient. she was admitted to the micu for treatment of her anemia. 2. gastrointestinal: the patient had concern for gi bleeds, both upper and lower, given her symptoms. the patient had ng lavage of clot but no active bleeding in the ed. the patient was admitted to the micu for further evaluation. she underwent egd which demonstrated patchy erosions of the mucosa in the antrum but no active bleeding. the duodenum demonstrated a 2 cm ulcer with visible vessel. no active bleeding in the bulb. she received seven injections of epinephrine and electrocautery with relief. she had h. pylori sent that was negative. she was started on b.i.d. ppi. the patient did not have any additional bleeding during her admission. her gi bleed was felt to be secondary to her nsaid use. 3. lfts: the patient was noted to have an elevated bilirubin upon admission which increased up to 11 during her admission with a direct of 8.0. this declined during her admission. she had an ultrasound which demonstrated diffuse hepatic infiltration, edematous gallbladder with normal ducts. i am unsure of whether or not she passed a stone versus tumor burden are two possibilities, although cholestasis secondary to her condition was felt to be the most likely diagnosis. her lfts slightly decreased during her admission and were felt to be stable for discharge. her coagulations remained stable. 4. metastatic breast cancer: the patient had been treated well with her gemcitabine, on cycle two. the patient was in the micu and noted to have one episode of change in mental status in which she became agitated and refused treatments. the patient's husband felt that this was likely just secondary to being tired of treatments. a head ct was obtained which demonstrated a 2 cm lesion with mass affect in the frontal lobe. neurology was consulted and steroids and phenytoin for seizure prophylaxis were started. the patient then underwent an mri of the brain which demonstrated a 2.0 by 1.7 enhancing mass in the white matter of the right frontal lobe with edema and mild impingement on the frontal of the right lateral ventricle. .................... foci were present in the occipital lobes as well as 5 mm foci in the cerebellum. radiation/oncology and neurosurgery were consulted. neurosurgery considered stereotactic radiation of these lesions. radiation/oncology also recommended radiation therapy. the patient decided to have radiation performed at where she had previous episodes of radiation. plan/disposition: the patient expresses a desire to leave the hospital and spend some time at home and return to her normal providers. the patient was discharged home with follow-up with dr. for oncology and dr. at , . discharge condition: stable. discharge status: the patient was discharged home with follow-up with dr. in two days, dr. on the following day for radiation, as well as the learning center for diabetic teaching given her new diagnosis of diabetes on steroids. discharge diagnosis: 1. metastatic breast ca to the lung, liver, and brain. 2. duodenal ulcer, status post electrocautery and epinephrine injection. 3. gastrointestinal bleed from duodenal ulcer. 4. change in mental status secondary to brain lesion. 5. elevated liver function tests secondary to cholestasis. 6. steroid-induced diabetes. discharge medications: 1. protonix 40 mg p.o. b.i.d. 2. dexamethasone 4 mg p.o. q. six hours. 3. regular insulin sliding scale while on prednisone. 4. lactulose 30 milliliters p.o. t.i.d. for encephalopathy. 5. zofran 2 mg p.o. p.r.n. nausea. 6. tylenol 650 mg p.o. p.r.n. 7. multivitamin one tablet p.o. q.d. 8. maalox p.r.n. 9. phenytoin 200 mg p.o. q.h.s. 10. colace 100 mg p.o. b.i.d. p.r.n. 11. dulcolax one tablet p.o. b.i.d. p.r.n. , m.d. dictated by: medquist36 procedure: endoscopic excision or destruction of lesion of duodenum diagnoses: anemia, unspecified pure hypercholesterolemia malignant neoplasm of liver, secondary other specified disorders of pancreatic internal secretion defibrination syndrome secondary malignant neoplasm of brain and spinal cord chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction secondary malignant neoplasm of bone and bone marrow 

Answer: The patient is high likely exposed to