Breast cancer is currently the most common form of cancer in women and will eventually affect 12 percent of the female population. Since 40% of patients with breast cancer develop musculoskeletal symptoms secondary to metastatic bone disease, the likelihood of patients presenting to chiropractic settings with this disorder is relatively high. The need for further imaging is stressed in the patient with a history of breast cancer and whose physical examination and plain film radiographs are inconclusive or suspicious. In these cases metastasis is the diagnosis until proven otherwise. To illustrate the physical examination and radiographic findings of metastatic bone disease secondary to breast cancer the case of a 46-year-old woman presenting to a chiropractic office for examination is presented. A brief discussion highlighting the incidence, prevalence, risk factors and management of the disease follows. A review of the distribution pattern of metastasis, with special emphasis on the major sites of skeletal metastasis, is presented. The need for referral for further imaging, when examination findings and radiographic results are suspicious or inconclusive, is stressed.
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