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Clip Marker Breast — SCE Medical Oncology MCQ

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HardBreast CancerClip Marker BreastSCE Medical Oncology

After neoadjuvant chemo-immunotherapy for node-positive triple-negative breast cancer, pathology shows a 32 mm fibrotic tumour bed containing 5% residual invasive cellularity and one 1 mm nodal deposit. Which framework integrates tumour-bed dimensions, cellularity and nodal burden into a continuous prognostic measure?

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Correct answer: A — Residual cancer burden continuous score and prognostic class

Residual cancer burden combines primary tumour-bed dimensions, invasive cellularity and nodal disease into a continuous score and class. Post-treatment pathological tumour and nodal anatomical stage: ypTN stage omits the continuous integration of tumour-bed area and residual cellularity. Miller-Payne primary-tumour histological response grading system: Miller-Payne assesses change in primary-tumour cellularity and not the full nodal-plus-bed burden. Preoperative endocrine prognostic index and risk group: PEPI applies after neoadjuvant endocrine treatment in ER-positive disease. Post-treatment Ki-67 proliferation index and response group: Ki-67 measures proliferation rather than total residual burden.

Reference: Reproducibility of residual cancer burden for breast cancer after neoadjuvant treatment (Published April 2016): https://pmc.ncbi.nlm.nih.gov/articles/PMC4830087/; NICE NG101 early and locally advanced breast cancer: recommendations (Updated April 2025; link maintenance March 2026): https://www.nice.org.uk/guidance/ng101/chapter/Recommendations