My sister diagnosed as a breast cancer patient. She under gone PET SCAN. Its result is- Elavated metabolic activity in multiple irregular enhancing lesions in the left breast, multifocal primary. Metabolically active thickening of the overlying skin and nipple areola complex,? involvement. Tiny soft tissue nodules in the subcutaneous tissues adjacent to the left breast, deposits. 2. Metabolically active enhancing soft tissue deposits on the left pectoral muscles, deposits. 3. Multiple metabolically active lymph nodes as described (left axillary, cervical, supraclavicular and mediastinal), metastases. 4. Metabolically active focal lesion in the segment VIII of liver as described, metastases. 5. No other site of elevated metabolic activity elsewhere in the body. Now what is her stage of CA? Whether she has to take chemo first or do the surgery first?