<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 50-year-old obese woman presents for a follow-up appointment regarding microcalcifications found in her left breast on a recent screening mammogram. The patient denies any recent associated symptoms. The past medical history is significant for polycystic ovarian syndrome PCOS, for which she takes metformin. Her menarche occurred at age 11, and the patient still has regular menstrual cycles. The family history is significant for breast cancer in her mother at the age of 72. The review of systems is notable for a 6.8 kg 15 lb weight loss in the past 2 months. The vital signs include: temperature 37.0C 98.6F, blood pressure 13070 mm Hg, pulse 82min, respiratory rate 17min, and oxygen saturation 98 on room air. On physical examination, the patient is alert and cooperative. The breast examination reveals no palpable masses, lymphadenopathy, or evidence of skin retraction. An excisional biopsy of the left breast is performed, and histologic examination demonstrates evidence of non-invasive malignancy. Which of the following is the most appropriate course of treatment for this patient?? A: Observation with bilateral mammograms every 6 months, B: Tamoxifen, C: Radiotherapy, D: Lumpectomy, E: Bilateral mastectomy,  <response>: This is a question about the appropriate treatment for a 50-year-old obese woman with non-invasive breast cancer found on a screening mammogram. Key points from the question stem:- 50-year-old obese woman - Microcalcifications found on screening mammogram- Biopsy showed non-invasive malignancy- Significant history of PCOS, family history of breast cancer- Recent unexplained weight lossThe choices given are observation with mammograms, tamoxifen, radiotherapy, lumpectomy, and bilateral mastectomy. For a diagnosis of non-invasive breast cancer, the most appropriate initial treatment is typically breast-conserving surgery such as lumpectomy, followed by radiotherapy. More extensive surgery like bilateral mastectomy would not usually be indicated for non-invasive disease. Tamoxifen may be considered for some cases, but radiotherapy would be more routinely recommended after lumpectomy. Observation alone would not be adequate treatment.D: Lumpectomy 