A 48-Year-Old Woman With Shortness of Breath and a Recent Diagnosis of Breast Cancer

A 48-year-old perimenopausal woman presented to our hospital in May 2024 with New York Heart Association functional class III dyspnea and a dry cough. Her symptoms had been ongoing for several months but worsened significantly in the weeks before admission. She reported fatigue but denied other constitutional symptoms such as fever, weight loss, or night sweats. There was no orthopnea or paroxysmal nocturnal dyspnea, and she was not taking any medications at the time. She had recently been diagnosed with treatment naïve de novo metastatic left breast cancer, stage cT4bN3cM1, with metastasis to the lungs, liver, bilateral ovaries, and bones. The pathology confirmed invasive ductal carcinoma, grade 1, with estrogen receptor and progesterone receptor positivity and human epidermal growth factor receptor 2-negative status. On presentation, she had not yet received any cancer treatment.