Breast and endocrine surgery: DCIS management: 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: DCIS management

Sample item

Screening mammography shows pleomorphic microcalcification, and biopsy shows high-grade comedo-type DCIS in a 2 cm area. What is the standard management?

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

The answer and the reasoning

D. Wide local excision with whole-breast radiotherapy, with no axillary dissection

DCIS is non-invasive and is treated with excision to clear margins plus radiotherapy, or mastectomy for extensive disease. Nodal disease is not expected, so sentinel biopsy is considered only with mastectomy. Endocrine therapy may reduce recurrence if ER positive.

Option by option

  • A. Observation alone

    Untreated high-grade DCIS may progress.

  • B. Axillary clearance with chemotherapy

    Axillary clearance and chemotherapy are not needed.

  • C. Tamoxifen alone

    Tamoxifen alone is inadequate local treatment.

  • D. Wide local excision with whole-breast radiotherapy, with no axillary dissection (correct)

    Correct. Excision plus radiotherapy is standard.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Wide local excision with whole-breast radiotherapy, with no axillary dissection. DCIS is non-invasive and is treated with excision to clear margins plus radiotherapy, or mastectomy for extensive disease.

Why is "Observation alone" not the answer?

Untreated high-grade DCIS may progress.

Why is "Axillary clearance with chemotherapy" not the answer?

Axillary clearance and chemotherapy are not needed.

Why is "Tamoxifen alone" not the answer?

Tamoxifen alone is inadequate local treatment.

What concept does this question test?

It tests Breast and endocrine surgery: DCIS management in General Surgery. Nodal disease is not expected, so sentinel biopsy is considered only with mastectomy. Endocrine therapy may reduce recurrence if ER positive.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: DCIS management?

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.