<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 56-year-old woman comes to the physician because she palpated a mass in her right breast during self-examination a week ago. Menarche was at the age of 14, and her last menstrual period was at the age of 51. Vital signs are within normal limits. Examination shows a nontender, firm and hard mass in the upper outer quadrant of the right breast. Mammography shows large, dense breasts, with a 1.7-cm mass in the right upper outer quadrant. The patient undergoes right upper outer quadrant lumpectomy with subsequent sentinel node biopsy, which reveals moderately differentiated invasive ductal carcinoma and micrometastasis to one axillary lymph node. There is no evidence of extranodal metastasis. The tumor tests positive for both estrogen and progesterone receptors and does not show human epidermal growth factor receptor 2 HER2 over-expression. Flow-cytometry reveals aneuploid tumor cells. Which of the following factors has the greatest effect on this patients prognosis?? A: Age, B: Tumor size, C: Nodal status, D: HER2 receptor status, E: Hormone receptor status,  <response>: This is a question about prognostic factors in breast cancer. The key details in the stem are:- 56 year old woman - Palpated a mass in her right breast - Menarche at 14, menopause at 51- Firm, hard mass in upper outer quadrant of right breast- Mammography showed 1.7cm mass in same location - Underwent lumpectomy and sentinel lymph node biopsy- Invasive ductal carcinoma, moderately differentiated - Micrometastasis to 1 lymph node- Tumor is ERPR positive, HER2 negative- Aneuploid tumor cellsThe choices list several tumor characteristics that can affect prognosis in breast cancer. Age, tumor size, nodal status, hormone receptor status, and HER2 status are all important prognostic factors. Of these, the most important factor affecting prognosis is typically nodal status, or whether the cancer has spread to lymph nodes. Micrometastasis to even a single lymph node indicates the cancer has started spreading beyond the breast, making it higher risk. Of the choices, nodal status would have the greatest effect on prognosis in this patient.C: Nodal status 