Dyspnea in a Patient With Metastatic Breast Cancer

A 76-year-old female with a history of estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast cancer presented to the pulmonary clinic with severe exertional dyspnea. She had no known history of cardiopulmonary disease and was in her usual state of health until 3 months prior to her presentation when she was diagnosed with a breast cancer recurrence in an axillary lymph node with associated osseous metastases. Subsequently, she had developed rapidly progressive exercise intolerance, orthopnea, and lower extremity edema.