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A 52-year-old female with metastatic breast carcinoma presents with moderate left shoulder pain. Figures A through C are radiographs, CT scan and bone scan images of her shoulder. Examination reveals mild tenderness but no swelling around the proximal humerus. Examination is negative for other causes of shoulder pain. According to the Mirels' scoring system, what is the most appropriate next step in treatment?
Observation is appropriate because her Mirels' score is 4.
Radiation therapy is appropriate because her Mirels' score is 6.
Prophylactic internal fixation with a proximal humeral locking plate is appropriate because her Mirels' score is 8.
Prophylactic fixation with an intramedullary nail is appropriate because her Mirels' score is 7.
Proximal humeral replacement is appropriate because her Mirels' score is 8.
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A 75-year-old man is brought to the ER after a fall. He complains of right leg pain, and a radiograph is shown in Figure A. Prior to operative fixation of the fracture, biopsy and staging procedures reveal that this is a metastatic lesion. Which of the following primary cancer diagnoses is associated with the shortest life expectancy following pathologic fracture?
An elderly female has just been diagnosed with lung cancer. If her cancer metastasizes to bone, what is the most common site of subsequent pathologic fracture?