A 62-year-old female with a history of breast cancer reports new-onset mid-thoracic pain that is worse at night and unrelieved by rest. What is the most appropriate next step?

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Multiple choice — select the best answer

ARecommend heat therapy and rest
BImmediate referral for advanced imaging
CInitiate conservative chiropractic care
DPrescribe over-the-counter pain medication

✓ Correct answer: B. Immediate referral for advanced imaging New-onset thoracic pain that is worse at night and unrelieved by rest in a patient with a history of cancer raises suspicion for metastatic disease. Immediate referral for advanced imaging is necessary to rule out spinal metastasis.

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A 62-year-old female with a history of breast cancer reports new-onset mid-thoracic pain that is worse at night and unrelieved by rest. What is the most appropriate next step?

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