<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 38-year-old woman comes to the physician for a 3-month history of bloody discharge from the right nipple. Her mother died of breast cancer at the age of 69 years. Mammography 6 months ago did not show any abnormalities. Examination of the breast shows expression of a small amount of serosanguinous fluid from the right nipple; there are no palpable breast masses or axillary lymphadenopathy. Ultrasonography of the right breast shows a single dilated duct. Which of the following is the most likely diagnosis?? A: Breast lipoma, B: Invasive ductal carcinoma, C: Phyllodes tumor, D: Paget disease of the breast, E: Intraductal papilloma,  <response>: This is a clinical case question asking about the most likely diagnosis in a 38-year-old woman with bloody nipple discharge from the right breast. The key findings are:- 3-month history of bloody discharge from the right nipple- Family history of breast cancer in mother at age 69- Normal mammogram 6 months ago- Expression of serosanguinous fluid from the right nipple on exam - No palpable breast masses or axillary lymphadenopathy- Ultrasound showing a single dilated duct in the right breastThe bloody nipple discharge localized to the right breast along with a dilated duct on ultrasound points towards an intraductal lesion. Paget disease and invasive ductal carcinoma are unlikely given the normal mammogram and lack of palpable mass. Phyllodes tumor would also likely present as a palpable mass. Breast lipomas do not cause nipple discharge. Therefore, the most likely diagnosis is an intraductal papilloma.E: Intraductal papilloma 