In reference to how ME came to the preliminary conclusion of sharp force trauma as COD even though her body was most likely in the final stages of decomp: Of course, X-rays and just observing wounds/knicks on her bones... Especially, if he wounded her in the chest, the breast bone is a rather flat surface, so, identifying damage in that area may be obvious, in some cases.
Also, maybe she was still clothed, so, the fabric could have been cut in some way creating a wound pattern to trace back to her body.
This is just a preliminary report as more evidence may come from her autopsy after a more thorough investigation: People can theoretically die in multiple ways at the same time: Meaning there could be other types of trauma to her body that has yet to be discovered; the sharp wounds were apparently the most lethal and obvious during the preliminary autopsy.