My chief complaint is severe lower back pain and pain in upper thighs. My medical history is as follows. Carcinoma of the breast three years back, followed by surgery, chemotherapy, and radiotherapy. I am on Tamoxifen for past 3 years, and now I am taking Arimidex. I have been suffering from osteoporosis for over 7 years. Before six years, I had severe osteopenia with maximum bone loss of 21% on L3 and spine, ribs, trunk, and arms with more on the left side.
I had undergone the following investigations. Before three years, I had FNAC which showed invasive ductal carcinoma, right breast ER+, PR+, Hercep score "0." Last month, I had an x-ray and MRI, which showed focal altered marrow intensity lesions seen in B/L pelvic bone, sacrum, and left upper femoral shaft consistent with metastasis. I also had a PET scan which showed metabolically active ill-defined lytic destructive lesions in post cortex shaft of left femur, right inferior pubic ramus, B/L iliac bones, sacrum, D5, 7, 11 and L1, 4, sternum, right 3, 5, 7 post ribs with mid-right paravertebral soft tissue lesion at D7 level likely metastasis.