Review Question - QID 6346

In 1980, a 32-year-old woman was found to have right breast mass, and a biopsy revealed adenocarcinoma. She underwent a mastectomy at that time, with no other treatment. Five years later, she noticed a lump in the left breast and underwent a left mastectomy. Seven lymph nodes were positive. In 2006, she now reports hip and thigh pain for the past 3 months. Figures 69a and 69b show AP and lateral radiographs of the femur. A bone scan shows a solitary lesion. Following radiographic staging, what is the next most appropriate step in management?