Question

Which of the following is true about the treatment of early breast carcinoma?

• A. Aromatase inhibitors are replacing tamoxifen in premenopausal women
• B. Post-mastectomy radiation therapy is given when 4 or more lymph nodes are positive
• C. Tamoxifen is not useful in post-menopausal women
• D. In premenopausal women, multidrug chemotherapy is given in selected patients

Hint:

Recall the nodal threshold that mandates post-mastectomy radiotherapy.

Answer 1

The Correct Option is B

Step 1: Post-mastectomy radiotherapy is indicated for higher-risk disease, classically when 4 or more axillary lymph nodes are positive (also for large tumours and positive margins). This statement is correct, so option b is the answer.
Step 2: Tamoxifen is effective in both pre- and post-menopausal hormone-receptor-positive disease, and is the drug of choice in premenopausal women. So option c (not useful post-menopause) is false.
Step 3: Aromatase inhibitors work by blocking peripheral conversion of androgen to estrogen, which is the main estrogen source in post-menopausal women. They are first line in post-menopausal women, NOT in premenopausal women, so option a is false.
Step 4: Premenopausal women generally should receive multidrug chemotherapy when adjuvant systemic therapy is indicated, not just selected patients, so option d as worded is false. The correct statement is option b.