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

HR-positive/HER2-negative breast cancer can relapse into bone metastases, which are often the first detectable distant site. In the current patient, the elevated alkaline phosphatase level was a clue to bone involvement.

The first location of distant metastasis varies by subtype. For instance, liver and lung metastases are more common in HER2-positive and triple-negative subtypes, although breast cancer can potentially spread to almost any site.


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