Breast and endocrine surgery: sentinel node biopsy and axillary management: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Breast and endocrine surgery: sentinel node biopsy and axillary management

Sample item

A woman with a 2 cm clinically node-negative breast cancer undergoes breast-conserving surgery with sentinel lymph node biopsy that shows 1 micrometastatic node and she will have whole-breast radiotherapy. According to Z0011-type evidence, what is the axillary management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Completion axillary dissection can be omitted

Sentinel biopsy uses blue dye and radiocolloid for clinically node-negative patients. In T1-T2 tumours treated with breast-conserving surgery and radiotherapy, with 1 to 2 positive sentinel nodes, completion dissection does not improve survival, so it is omitted.

Option by option

  • A. Mandatory level III axillary clearance

    Clearance adds morbidity without survival benefit here.

  • B. Repeat sentinel biopsy

    Repeating the biopsy has no basis.

  • C. Completion axillary dissection can be omitted (correct)

    Correct. Axillary dissection can be omitted in these circumstances.

  • D. Mastectomy

    Mastectomy is not required.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Completion axillary dissection can be omitted. Sentinel biopsy uses blue dye and radiocolloid for clinically node-negative patients.

Why is "Mandatory level III axillary clearance" not the answer?

Clearance adds morbidity without survival benefit here.

Why is "Repeat sentinel biopsy" not the answer?

Repeating the biopsy has no basis.

Why is "Mastectomy" not the answer?

Mastectomy is not required.

What concept does this question test?

It tests Breast and endocrine surgery: sentinel node biopsy and axillary management in General Surgery. In T1-T2 tumours treated with breast-conserving surgery and radiotherapy, with 1 to 2 positive sentinel nodes, completion dissection does not improve survival, so it is omitted.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast and endocrine surgery: sentinel node biopsy and axillary management?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.