Extract
A sixty-two-year-old woman was admitted to the hospital because of an inability to walk secondary to severe pain in the left hip as well as a large, fungating infiltrating ductal carcinoma of the breast. Computed tomography demonstrated multiple areas of osseous metastases. The left femoral neck and acetabulum were at risk for impending fracture. In discussing the diagnosis, prognosis, and treatment with the patient, she indicated that she wanted treatment that would slow and palliate the cancer, including chemotherapy and hormonal therapy. She did not wish for cardiopulmonary resuscitation or mechanical intubation to be performed. A do-not-resuscitate order was entered in her chart. However, she agreed to surgery and radiation therapy to stabilize the metastatic lesion in the femur, since it could improve her mobility and her overall quality of life.