In this next case scenario a 60-year-old woman was diagnosed with carcinoma of the breast 5 years ago. It was treated with a mastectomy and radiotherapy. She was well until 6 months ago, when she was diagnosed with secondary carcinoma of the femur. She was admitted to hospital 2 days ago with a pathological fracture. After a week in hospital she suffered a massive pulmonary embolism and died shortly after.

•Pulmonary embolism is the immediate cause of death on line A of Part 1.

•The pathological fracture of the femur due to metastases are intermediate causes

•Breast cancer is the underlying cause of death, so it is reported on the lowest used line of Part 1.