Breast: receptor status: practice question

A Pathology 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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Pathology · Breast: receptor status

Sample item

A 48-year-old woman has invasive ductal carcinoma that is ER-positive, PR-positive and HER2 amplified on FISH. Which therapeutic combination is directly guided by these results?

APlatinum chemotherapy aloneBTrastuzumab for ER and tamoxifen for HER2CRadiotherapy alone as no targeted therapy existsDTamoxifen or an aromatase inhibitor for ER, with trastuzumab for HER2

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

The answer and the reasoning

D. Tamoxifen or an aromatase inhibitor for ER, with trastuzumab for HER2

Hormone receptor positivity predicts benefit from endocrine therapy (tamoxifen, or an aromatase inhibitor after menopause), while HER2 overexpression predicts response to anti-HER2 antibodies such as trastuzumab. Triple-negative tumours lack all three markers and rely on chemotherapy. The combination is guided by receptors, not by histological type.

Option by option

A. Platinum chemotherapy alone
Platinum alone ignores receptor-directed therapy that improves survival.
B. Trastuzumab for ER and tamoxifen for HER2
This swaps the targets: trastuzumab acts on HER2 and tamoxifen on ER.
C. Radiotherapy alone as no targeted therapy exists
Targeted therapies exist for both markers, so radiotherapy alone is incorrect.
D. Tamoxifen or an aromatase inhibitor for ER, with trastuzumab for HER2 (correct)
Correct. Endocrine therapy targets ER, and trastuzumab targets HER2.

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.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Tamoxifen or an aromatase inhibitor for ER, with trastuzumab for HER2. Hormone receptor positivity predicts benefit from endocrine therapy (tamoxifen, or an aromatase inhibitor after menopause), while HER2 overexpression predicts response to anti-HER2 antibodies such as trastuzumab.

Why is "Platinum chemotherapy alone" not the answer?

Platinum alone ignores receptor-directed therapy that improves survival.

Why is "Trastuzumab for ER and tamoxifen for HER2" not the answer?

This swaps the targets: trastuzumab acts on HER2 and tamoxifen on ER.

Why is "Radiotherapy alone as no targeted therapy exists" not the answer?

Targeted therapies exist for both markers, so radiotherapy alone is incorrect.

What concept does this question test?

It tests Breast: receptor status in Pathology. Triple-negative tumours lack all three markers and rely on chemotherapy. The combination is guided by receptors, not by histological type.

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: receptor status?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.