25th February 2025

A 61-year-old woman with breast cancer with pulmonary and bony metastases presents with a 3-week history of enlarging lumps in her left armpit

A 61-year-old woman with breast cancer with pulmonary and bony metastases presents with a 3-week history of enlarging lumps in her left armpit. She also complains of a 2-day history of lower back pain and is finding it difficult to walk. On examination, she has reduced power bilaterally and reduced sensation perianally. She has recently been told by her oncologist that she will need to switch treatment regimes as her cancer was not responding to chemotherapy.

Which is the most appropriate first-line investigation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.