Thorax: breast lymphatics: practice question

A Anatomy 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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Anatomy · Thorax: breast lymphatics

Sample item

A 40-year-old woman has a 2 cm carcinoma in the upper inner quadrant of the breast, and the axillary nodes are clinically negative. Which additional nodal group is at particular risk of spread?

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

The answer and the reasoning

D. Internal mammary (parasternal) nodes along the internal thoracic vessels

About three quarters of breast lymph drains to the axillary nodes, mainly the anterior (pectoral) group. The medial part of the breast also drains to the internal mammary nodes along the internal thoracic vessels, so inner quadrant tumours can spread there without axillary involvement.

Option by option

  • A. Superficial inguinal nodes

    The inguinal nodes drain the lower limb and perineum, not the breast.

  • B. Subscapular nodes of the posterior axillary wall

    The subscapular nodes drain the back and scapular region, not the breast.

  • C. Supraclavicular nodes directly from the breast

    Supraclavicular nodes are reached later via the apical axillary nodes, not directly.

  • D. Internal mammary (parasternal) nodes along the internal thoracic vessels (correct)

    Correct. Medial quadrant lymph reaches the parasternal nodes in the intercostal spaces.

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.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is D, Internal mammary (parasternal) nodes along the internal thoracic vessels. About three quarters of breast lymph drains to the axillary nodes, mainly the anterior (pectoral) group.

Why is "Superficial inguinal nodes" not the answer?

The inguinal nodes drain the lower limb and perineum, not the breast.

Why is "Subscapular nodes of the posterior axillary wall" not the answer?

The subscapular nodes drain the back and scapular region, not the breast.

Why is "Supraclavicular nodes directly from the breast" not the answer?

Supraclavicular nodes are reached later via the apical axillary nodes, not directly.

What concept does this question test?

It tests Thorax: breast lymphatics in Anatomy. The medial part of the breast also drains to the internal mammary nodes along the internal thoracic vessels, so inner quadrant tumours can spread there without axillary involvement.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Thorax: breast lymphatics?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy 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.