Breast: 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

Sample item

A 55-year-old woman has a unilateral scaly, eczema-like rash of the nipple and areola that has not responded to topical steroids for two months. What is the next best step?

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

The answer and the reasoning

B. Full-thickness punch or wedge biopsy of the nipple

A persistent unilateral nipple eczema that does not respond to treatment is Paget disease of the breast until proven otherwise, and it is associated with an underlying ductal carcinoma in situ or invasive cancer. Biopsy shows Paget cells, and imaging then looks for the underlying lesion.

Option by option

  • A. Prolonged topical antifungal therapy

    Antifungals are inappropriate and only delay the diagnosis of malignancy.

  • B. Full-thickness punch or wedge biopsy of the nipple (correct)

    Correct. Biopsy confirms Paget cells and guides further treatment.

  • C. Reassurance and review in six months

    Reassurance misses a possible underlying carcinoma.

  • D. Mammography alone without biopsy

    Mammography helps find an underlying lesion but cannot establish the diagnosis without tissue.

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 General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Full-thickness punch or wedge biopsy of the nipple. A persistent unilateral nipple eczema that does not respond to treatment is Paget disease of the breast until proven otherwise, and it is associated with an underlying ductal carcinoma in situ or invasive cancer.

Why is "Prolonged topical antifungal therapy" not the answer?

Antifungals are inappropriate and only delay the diagnosis of malignancy.

Why is "Reassurance and review in six months" not the answer?

Reassurance misses a possible underlying carcinoma.

Why is "Mammography alone without biopsy" not the answer?

Mammography helps find an underlying lesion but cannot establish the diagnosis without tissue.

What concept does this question test?

It tests Breast in General Surgery. Biopsy shows Paget cells, and imaging then looks for the underlying lesion.

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 Breast?

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.