A 58-year-old woman with a 3 cm breast cancer has 4 positive axillary lymph nodes on final histopathology after mastectomy. She has no distant metastases. What is the recommended adjuvant treatment?

• A Chemotherapy only
• B Targeted therapy with trastuzumab
• C Endocrine therapy only
• D Radiotherapy to the chest wall and regional lymph nodes ✓

Explanation

Post-mastectomy radiotherapy is indicated when there are 4 or more positive axillary lymph nodes (as well as for T3-T4 tumors). It reduces locoregional recurrence and improves overall survival. While chemotherapy and endocrine therapy (if ER-positive) are also indicated, the question specifically asks about the adjuvant treatment that is uniquely indicated by this nodal status.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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