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: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: nausea and vomiting major surgical or invasive procedure: 1. frontal craniotomy for resection. 2. intraoperative image guidance. 3. microscopic dissection. 4. removal of intracranial/intraventricular tumor. 5. duraplasty. 6. left sided evd preoperative placement history of present illness: ms. is a 62 y/o female with dm who reports that for the past 2-3 weeks she's had intermittent nausea/vomiting. she any abdominal pain with the vomiting and does not vomit blood. she says that she has lost ~5 lbs recently. she also developed dizziness and loss of balance over the past few days. she fell at home today and was taken to er where head ct reveals right frontal circular lesion along with right temporal lesion. contrast was not given with this scan, but mass effect and midline shift is noted with effacement of frontal horns. neurosurgery consulted to evaluate intracranial lesions. past medical history: vaginitis bronchitis/asthma fibroids anemia hypertension gastrointestinal urinary tract infection adult onset diabetes mellitus breast cancer er positive, her-2/neu negative s/p wide excision and axillary dissection in . pathology revealed a 4.5 cm grade iii infiltrating ductal carcinoma with no extensive intraductal component and no lymphatic vascular invasion; however, 12 of the 27 lymph nodes were positive with the largest being 1.2 cm. she underwent chemotherapy followed by radiation therapy, which he finished on and was started on , aromatase inhibitor. social history: lives at home; denies tobacco, etoh or ivdu family history: noncontributory physical exam: o: t: 97.2 bp: 162/106 hr: 108 r 18 o2sats 98% 2l nc gen: wd/wn, comfortable, nad. heent: pupils: bilaterally eoms intact neck: supple. lungs: cta bilaterally. cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect, but lethargic. orientation: oriented to person, place, and date. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, to mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength full power throughout; however, she periodically neglects the left arm and leg. right pronator drift present. sensation: intact to light touch, propioception, pinprick and vibration bilaterally. toes downgoing bilaterally coordination: normal on finger-nose-finger, rapid alternating movements, heel to shin pertinent results: 11:40pm wbc-9.3 rbc-5.01 hgb-13.8 hct-38.8 mcv-78* mch-27.6 mchc-35.6* rdw-14.8 11:40pm neuts-92.6* bands-0 lymphs-5.2* monos-1.6* eos-0.3 basos-0.3 11:40pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 11:40pm plt smr-high plt count-489* 06:47pm k+-3.9 06:45pm glucose-213* urea n-12 creat-0.8 sodium-135 potassium-5.7* chloride-94* total co2-26 anion gap-21* 06:45pm estgfr-using this 06:45pm calcium-10.7* phosphate-4.8* magnesium-1.9 06:45pm pt-13.2 ptt-24.9 inr(pt)-1.1 mri : multiple large enhancing masses within the brain with surrounding vasogenic edema most consistent with metastatic disease. the largest of these lesions is within the right frontal lobe measuring 28 x 31 mm which causes 11 mm of leftward midline shift and subfalcine herniation. a smaller lesion in the right cerebellar peduncle partially obliterates the fourth ventricle. no evidence of hydrocephalus or uncal herniation at this time. close followup is recommended. mri : 1. status post right frontal craniotomy with resection of right frontal tumor. peripheral enhancement in the resection cavity is concerning for residual tumor. 11 mm of leftward midline shift remains. 2. postoperative changes about the right frontal craniotomy site. mild pneumocephalus and small amount of intraventricular air is consistent with the patient's operative history. 3. enhancing lesions in the right temporal lobe and right mid brain consistent with metastatic disease. increased enhancement within the fourth ventricle is concerning for leptomeningeal extension of tumor. 4. small amount of hemorrhage along the resection tract better seen on the ct scan performed earlier the same day. ct torso: 1. left breast seroma versus lymphocele. left breast skin thickening and fibrotic changes in the left upper lobe which are consistent with post- radiation change. left axillary soft tissue consistent with scarring from axillary node dissection. 2. 5-mm right middle lobe pulmonary nodule, stable since . 3. fatty liver. 4. diverticulosis without diverticulitis. pathology: 1. brain, right side, tumor, "frozen" (a): metastatic carcinoma, histologically similar to the breast primary ductal carcinoma (s07-). there is extensive necrosis and cytologic atypia, presumably related to the radiation treatment. 2. brain, right, tumor (b-d): metastatic carcinoma, histologically similar to the breast primary ductal carcinoma (s07-). there is extensive necrosis and cytologic atypia, presumably related to the radiation treatment. the immunoperoxidase stains (er/pr her-2, mammoglobin, gcdfp) results will be reported in the addendum. the immunoperoxidase stains show the tumor is positive for estrogen receptors and mammoglobin, and negative for progesterone receptor and gcdfp. this pattern is consistent with breast primary carcinoma, and is the same result as in the report s07-5242m for the primary tumor. the her/neu stain is largely negative; fish assay for gene amplification is in progress, and the results will be reported separately. brief hospital course: ms. was admitted to the neurosurgery service. imaging was done which showed large enhancing masses within the brain with surrounding vasogenic edema most consistent with metastatic disease. she was therefore evaluated for tumor resection. she was loaded with dilantin and started on steroids. on she was taken to the or for craniotomy, removal of intracranial/ intraventricular tumor and left sided evd preoperative placement. post-operatively she was monitored in the icu. on the 10th a repeat ct was done which showed significant swelling, therefore she was restarted on mannitol and her evd was pulled back. an mri was repeated which did not show evidence of stroke. her exam was remarkable for significant fluctuations in mental status, therefore she was rescanned on . this time, she was noted to have worsening mass effect and smaller ventricles, the evd was therefore changed from 10 to 15cm. it was raised to 20cm the following day. her exam continued to fluctuate. the drain was clamped intermittently for several days, but she failed these clamping trials repeatedly, therefore she was taken to the or on th 18th for shunt placement. in the interim, she was tapered off the mannitol and her dilantin was rebolused as needed. she was also treated with cipro for a uti. given her waxing mental status, she was evaluated by speech therapy for concern for aspiration. an ng was place to provide tube feeds but she able to tolerate thins. therefore, she was re-evaluated by speech and her diet was upgraded to thin liquids and soft solids. lastly, prior to discharge she had her xrt planning session. she was then discharged to rehab and will have further xrt treatment in rehab. medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 2 puffs four times daily as needed for cough or wheezing amlodipine - 2.5 mg tablet - 1 tablet(s) by mouth once a day fluticasone - 220 mcg/actuation aerosol - four puffs inh twice a day ibuprofen - 600 mg tablet - 1 tablet(s) by mouth every 8 hours with food as needed for pain letrozole ] - 2.5 mg tablet - 1 tablet(s) by mouth once a day metformin - 850 mg tablet - 1 tablet(s) by mouth twice a day moexipril-hydrochlorothiazide - 15-12.5mg tablet - two tablet(s) by mouth once a day pantoprazole - 40 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day tolterodine - 4 mg capsule, sust. release 24 hr - 1 capsule(s) by mouth daily aspirin - 81 mg tablet, delayed release (e.c.) - 81 tablet(s) by mouth once a day pyridoxine - 100 mg tablet - 1 tablet(s) by mouth once a day discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 3. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 4. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 5. amlodipine 2.5 mg tablet sig: one (1) tablet po daily (daily). 6. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours) as needed. 7. moexipril 15 mg tablet sig: one (1) tablet po daily (daily). 8. tolterodine 1 mg tablet sig: two (2) tablet po bid (2 times a day). 9. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 10. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). 11. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: inhalation q4h (every 4 hours) as needed. 12. phenytoin 100 mg/4 ml suspension sig: one (1) po tid (3 times a day). 13. dexamethasone sodium phosphate 4 mg/ml solution sig: one (1) injection tid (3 times a day). discharge disposition: extended care facility: & rehab center - discharge diagnosis: metastatic breast cancer discharge condition: stable, abulic discharge instructions: discharge instructions for craniotomy ?????? have a family member check your incision daily for signs of infection ?????? take your pain medicine as prescribed ?????? exercise should be limited to walking; no lifting, straining, excessive bending ?????? you may wash your hair only after sutures and/or staples have been removed ?????? you may shower before this time with assistance and use of a shower cap ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, ibuprofen etc. ?????? if you have been prescribed an anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing as ordered ?????? clearance to drive and return to work will be addressed at your post-operative office visit call your surgeon immediately if you experience any of the following: ?????? new onset of tremors or seizures ?????? any confusion or change in mental status ?????? any numbness, tingling, weakness in your extremities ?????? pain or headache that is continually increasing or not relieved by pain medication ?????? any signs of infection at the wound site: redness, swelling, tenderness, drainage ?????? fever greater than or equal to 101?????? f followup instructions: please return to the office in days for removal of your staples/sutures please call to schedule an appointment with dr. in brain clinic. procedure: venous catheterization, not elsewhere classified other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain enteral infusion of concentrated nutritional substances ventricular shunt to abdominal cavity and organs intravascular imaging of intrathoracic vessels other repair of cerebral meninges diagnoses: obstructive hydrocephalus urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of malignant neoplasm of breast secondary malignant neoplasm of brain and spinal cord personal history of irradiation, presenting hazards to health anemia in neoplastic disease dysphagia, unspecified 

Answer: The patient is high likely exposed to