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Export to Word and you now get a document that looks just like your PDF — only editable. You get the fonts if the PDF came from a document, and even if it came from a scan you get a reasonable version of the document via OCR. Export to Excel also gives you faithful formatting, and you can simply copy text out of an unlocked PDF, with or without formatting, more easily.
Adobe says it worked with Microsoft on Acrobat integration, and it's possible the company went a little overboard: having PDF appear so many times in the Backstage menu is a little overwhelming and could be confusing — especially as you still have the built-in PDF creation tools.
The Acrobat X ribbon tab in Office 2010 has far fewer options, and they're the ones you need. You can turn your document into a straightforward PDF (with the option to transfer footnotes, endnotes and comments), or make a PDF that's designed to share. The option to send out a document for comment that people can't edit — so you don't have to manage multiple incompatible revisions — could be very useful.