A 36-year-old woman with past medical history of neurofibromatosis-1 (NF1) presented to the emergency department with left breast pain and rapid enlargement her left breast. She noted history of a palpable left breast mass for the past 13 years. Physical examination revealed a firm, nonmobile mass that encompassed a majority of the breast with the left approximately five times the size of the right (Figure 1). She was referred for clinical evaluation and imaging. The

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