Dr. Theodore J. Hahn, Fellow in Endocrinology, the Jewish Hospital of St. Louis, and Assistant in Medicine, Washington University School of Medicine: A 58-year-old Negro woman was hospitalized on July 9, 1970, for treatment of metastatic carcinoma of the breast. The patient had experienced a normal menopause at age 50 years. Four years later, she was found to have a mass in her right breast which at operation proved to be an adenocarcinoma with axillary metastases. She underwent a right radical mastectomy and cobalt 60 radiation therapy to the axilla. The only evidence of metastatic disease at that time was an osteoblastic lesion, 3×5 cm in size, in the head of the right femur. This area was irradiated with cobalt 60 and to date has not progressed.
The patient had been subsequently asymptomatic until May 1970, when she began to have gradually ing dyspnea on exertion, orthopnea, nonproductive cough, and