A 45-year-old woman undergoes sentinel lymph node biopsy (SLNB) for a 2.2 cm invasive ductal carcinoma of the right breast. Two sentinel nodes are found to contain isolated tumour cells (ITC, defined as clusters ≤0.2 mm). According to AJCC 8th edition, the nodal stage is:
- A pN1mi
- B pN1a
- C pN0(i+) ✓
- D pN0
Correct answer: C. pN0(i+)
Explanation
Isolated tumour cells (ITC) are single cells or small clusters ≤0.2 mm detected in sentinel nodes, categorised as pN0(i+) in AJCC 8th edition — not pN1mi (which requires >0.2 mm but ≤2 mm micrometastases). pN0(i+) does not mandate axillary lymph node dissection under current guidelines. This distinction matters clinically because pN1mi may influence adjuvant chemotherapy decisions.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.