Breast and endocrine surgery: core biopsy before neoadjuvant therapy: 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: core biopsy before neoadjuvant therapy

Sample item

A woman has a 5 cm clinically malignant breast mass and the team plans neoadjuvant chemotherapy to downstage it. FNAC shows malignant cells. What should be done before chemotherapy starts?

AImage-guided core needle biopsy for histology and receptor statusBExcision biopsy of the whole lumpCImmediate mastectomy without further testsDStart chemotherapy based on FNAC alone

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

The answer and the reasoning

A. Image-guided core needle biopsy for histology and receptor status

Neoadjuvant treatment needs a core biopsy because FNAC cannot grade the tumour, distinguish invasive from in situ disease, or give reliable ER, PR and HER2 status that determines the drugs used.

Option by option

A. Image-guided core needle biopsy for histology and receptor status (correct)
Correct. Core biopsy gives histology and receptor status needed to plan therapy.
B. Excision biopsy of the whole lump
Excision biopsy removes the target tumour before neoadjuvant therapy and is unnecessary.
C. Immediate mastectomy without further tests
Mastectomy at this point forgoes the planned downstaging.
D. Start chemotherapy based on FNAC alone
FNAC alone cannot provide receptor status.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Image-guided core needle biopsy for histology and receptor status. Neoadjuvant treatment needs a core biopsy because FNAC cannot grade the tumour, distinguish invasive from in situ disease, or give reliable ER, PR and HER2 status that determines the drugs used.

Why is "Excision biopsy of the whole lump" not the answer?

Excision biopsy removes the target tumour before neoadjuvant therapy and is unnecessary.

Why is "Immediate mastectomy without further tests" not the answer?

Mastectomy at this point forgoes the planned downstaging.

Why is "Start chemotherapy based on FNAC alone" not the answer?

FNAC alone cannot provide receptor status.

What concept does this question test?

It tests Breast and endocrine surgery: core biopsy before neoadjuvant therapy in General Surgery. The correct option holds because: Correct. Core biopsy gives histology and receptor status needed to plan therapy.

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: core biopsy before neoadjuvant therapy?

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.