Breast: phyllodes tumour: 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.

Try it

General Surgery · Breast: phyllodes tumour

Sample item

A 46-year-old woman has an 8 cm smooth, firm, mobile breast lump that has doubled in size over 3 months. There are no palpable axillary nodes. Core biopsy shows a cellular stroma with leaf-like architecture and mild stromal atypia. What is the most appropriate treatment?

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

The answer and the reasoning

C. Wide local excision with a clear margin of at least 1 cm

Phyllodes tumours are stromal neoplasms that recur locally if shelled out, so they need excision with a 1 cm margin of normal breast tissue. They spread through the blood rather than lymphatics, so axillary clearance is not needed. Mastectomy is reserved for large lesions relative to breast size, and chemotherapy has no established role.

Option by option

  • A. Enucleation of the lump alone

    Simple enucleation leaves microscopic stromal extensions and is followed by frequent local recurrence.

  • B. Modified radical mastectomy with axillary clearance

    Axillary nodal involvement is rare because spread is haematogenous, so clearance adds morbidity without benefit.

  • C. Wide local excision with a clear margin of at least 1 cm (correct)

    Correct. A wide margin prevents the local recurrence typical of phyllodes tumours.

  • D. Neoadjuvant chemotherapy followed by observation

    Phyllodes tumours are not chemosensitive, and observation after chemotherapy leaves the primary lesion untreated.

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 C, Wide local excision with a clear margin of at least 1 cm. Phyllodes tumours are stromal neoplasms that recur locally if shelled out, so they need excision with a 1 cm margin of normal breast tissue.

Why is "Enucleation of the lump alone" not the answer?

Simple enucleation leaves microscopic stromal extensions and is followed by frequent local recurrence.

Why is "Modified radical mastectomy with axillary clearance" not the answer?

Axillary nodal involvement is rare because spread is haematogenous, so clearance adds morbidity without benefit.

Why is "Neoadjuvant chemotherapy followed by observation" not the answer?

Phyllodes tumours are not chemosensitive, and observation after chemotherapy leaves the primary lesion untreated.

What concept does this question test?

It tests Breast: phyllodes tumour in General Surgery. They spread through the blood rather than lymphatics, so axillary clearance is not needed. Mastectomy is reserved for large lesions relative to breast size, and chemotherapy has no established role.

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: phyllodes tumour?

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.