Which of the following is an absolute contraindication to breast conserving surgery with radiotherapy?

• A Tumour size of 3 cm in a small breast
• B Axillary lymph node metastasis
• C First trimester pregnancy ✓
• D Age younger than 35 years

Explanation

Radiotherapy is absolutely contraindicated in the first trimester of pregnancy because of fetal radiation exposure, so breast conservation with adjuvant radiotherapy cannot be offered at that stage. Relative contraindications include a large tumour to breast ratio, multicentric disease, prior chest irradiation and collagen vascular disease. Nodal positivity and young age influence systemic therapy decisions but do not preclude conservation, and a 3 cm tumour may still be conserved after downstaging or in a sufficiently large breast.

Reference: Schwartz's Principles of Surgery, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.