A 58-year-old woman presents to her physician complaining of rib and back pain following a trip-and-fall accident. She was concerned that she may have broken something. On physical exam, the physican notes some rib tenderness, but also finds a palpable mass in her right breast. The woman says she does not perform monthly self-exams on her breasts and has not had a breast exam since her last checkup several years ago. A mammogram, rib films, and spine films are ordered by the physician. The mammogram (click button for image) shows a large mass consistent with cancer in her right breast, and the bone films show multiple osseous lesions consistent with metastatic disease.