Breast: lobular carcinoma in situ: 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: lobular carcinoma in situ

Sample item

A 45-year-old woman has a core biopsy of screening-detected calcification that shows classic lobular carcinoma in situ as an incidental finding, with no atypical features or invasive disease. What is the most appropriate management?

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

The answer and the reasoning

B. Surveillance with risk-reduction counselling

Classic LCIS is a marker of increased risk for invasive cancer in either breast, rather than an obligate precursor, and it is often multicentric and bilateral. Excision margins are not required, and treatment is annual surveillance with discussion of chemoprevention such as tamoxifen. Pleomorphic LCIS is managed more like DCIS.

Option by option

  • A. Wide local excision with radiotherapy

    Margin-negative excision and radiotherapy are used for DCIS, not for classic LCIS.

  • B. Surveillance with risk-reduction counselling (correct)

    Correct. Classic LCIS is a risk marker that is followed, with chemoprevention discussed.

  • C. Axillary clearance

    LCIS does not spread to nodes, so axillary surgery has no role.

  • D. Unilateral simple mastectomy with sentinel node biopsy

    Mastectomy is overtreatment, since the risk is bilateral and diffuse rather than confined to one site.

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 B, Surveillance with risk-reduction counselling. Classic LCIS is a marker of increased risk for invasive cancer in either breast, rather than an obligate precursor, and it is often multicentric and bilateral.

Why is "Wide local excision with radiotherapy" not the answer?

Margin-negative excision and radiotherapy are used for DCIS, not for classic LCIS.

Why is "Axillary clearance" not the answer?

LCIS does not spread to nodes, so axillary surgery has no role.

Why is "Unilateral simple mastectomy with sentinel node biopsy" not the answer?

Mastectomy is overtreatment, since the risk is bilateral and diffuse rather than confined to one site.

What concept does this question test?

It tests Breast: lobular carcinoma in situ in General Surgery. Excision margins are not required, and treatment is annual surveillance with discussion of chemoprevention such as tamoxifen. Pleomorphic LCIS is managed more like DCIS.

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: lobular carcinoma in situ?

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.