Dr. Joseph S. Barr, Jr.: A 53-year-old white woman was admitted to the Massachusetts General Hospital complaining of severe pain in the right hip. The patient had twisted the right leg in moving to answer the telephone a few hours before admission.
Medical history included a right radical mastectomy four years before admission for grade 2 adenocarcinoma of the breast. More than 80 regional nodes were involved with tumor. She was treated with 4,000 roentgens of high-voltage radiation to the right axilla.
One year before admission the patient had undergone a left radical mastectomy for a scirrhous-type adenocarcinoma. There was evidence of malignancy in 13 regional nodes. Alkaline phosphatase value was 5.3 Bodansky units.
Six months later ureteral colic developed, and retroperitoneal metastases in the right flank were found at the time of open biopsy. The alkaline phosphatase value was 8.4 Bodansky units. The patient was treated with 2,400 R