A woman with breast carcinoma is found to have ipsilateral infraclavicular and supraclavicular nodal metastases on imaging and biopsy. To which N category does this correspond in the TNM system?

• A N3a
• B N3b
• C N2b
• D N3c ✓

Explanation

Involvement of ipsilateral supraclavicular nodes is classified N3c regardless of accompanying axillary nodal disease. N3a denotes infraclavicular nodes, N3b denotes level II or III axillary nodes combined with internal mammary nodes, and N2b refers to clinically apparent fixed or matted ipsilateral axillary nodes without internal mammary involvement. Supraclavicular disease still represents stage III regional spread, not distant metastasis.

Reference: AJCC Cancer Staging Manual, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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