Skill Checkup: A 56-Year-Old Woman With a History of Breast Cancer and Pain in Her Ribs and Spine

Pavani Chalasani, MD, MPH;  Stefania Morganti, MD


January 23, 2023

After confirming a suspicion of metastatic relapse by imaging, confirmation of diagnosis through biopsy is recommended, whenever feasible.

When a metastasis from breast cancer is confirmed, assessment of HR (ie, estrogen receptor and progesterone receptor) status as well as HER2 status via immunohistochemistry staining is recommended.

In patients without neurologic symptoms, brain MRI is not required for screening purposes. Similarly, a mammogram is rarely indicated in patients with metastatic breast cancer.


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