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Breast Cancer — SCE Medical Oncology MCQ

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HardBreast CancerBreast CancerSCE Medical Oncology

After breast-conserving surgery for a 25 mm invasive breast cancer, sentinel-node histology shows a single 0.5 mm deposit and no macrometastasis. Preoperative axillary ultrasound was normal. What axillary treatment follows NICE NG101?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — No further axillary surgery or axillary radiotherapy

Explanation lettering: E = shown as A · D = shown as B · B = shown as D · A = shown as E

A is correct. A 0.5 mm deposit is a sentinel-node micrometastasis. NICE NG101 advises no further axillary treatment when micrometastases, but no macrometastases, are found after primary surgery. Completion clearance and axillary radiotherapy add morbidity outside that recommendation. Repeat sentinel-node biopsy has no established role after the node has already staged the axilla, and neoadjuvant treatment cannot be given after definitive breast surgery. Systemic and whole-breast radiotherapy decisions still follow tumour biology and breast-conservation planning; avoiding further axillary treatment does not mean omitting the rest of adjuvant care.

Reference: NICE NG101 sentinel-node micrometastasis recommendations: https://www.nice.org.uk/guidance/ng101/chapter/Recommendations