Breast and endocrine surgery: Paget disease of the nipple: 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 and endocrine surgery: Paget disease of the nipple

Sample item

A woman has a unilateral scaly, eczematous nipple lesion not responding to topical steroids for 3 months. What is the next step?

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

The answer and the reasoning

A. Biopsy of the nipple and breast imaging for underlying carcinoma

Paget disease of the nipple is intraepidermal spread of malignant cells from underlying DCIS or invasive carcinoma in most cases. Punch or wedge biopsy shows large vacuolated Paget cells and imaging identifies the underlying lesion.

Option by option

  • A. Biopsy of the nipple and breast imaging for underlying carcinoma (correct)

    Correct. Biopsy and imaging are required.

  • B. Antifungal cream

    Antifungals do not treat Paget disease.

  • C. Observation for 1 year

    Delay risks progression.

  • D. Reassure and continue steroids

    Persistent eczema needs tissue diagnosis.

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 A, Biopsy of the nipple and breast imaging for underlying carcinoma. Paget disease of the nipple is intraepidermal spread of malignant cells from underlying DCIS or invasive carcinoma in most cases.

Why is "Antifungal cream" not the answer?

Antifungals do not treat Paget disease.

Why is "Observation for 1 year" not the answer?

Delay risks progression.

Why is "Reassure and continue steroids" not the answer?

Persistent eczema needs tissue diagnosis.

What concept does this question test?

It tests Breast and endocrine surgery: Paget disease of the nipple in General Surgery. Punch or wedge biopsy shows large vacuolated Paget cells and imaging identifies 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 and endocrine surgery: Paget disease of the nipple?

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.