Question

Which of the following is true about the treatment of early breast carcinoma?

• A. Aromatase inhibitors are replacing tamoxifen in premenopausal women
• B. Post-mastectomy radiation therapy is given when 4 or more lymph nodes are positive
• C. Tamoxifen is not useful in post-menopausal women
• D. In premenopausal women, multidrug chemotherapy is given in selected patients

Hint:

Recall the nodal threshold that mandates post-mastectomy radiotherapy.

Answer 1

The Correct Option is B

Step 1: Each option must be tested against breast cancer management rules. The locoregional question first: after mastectomy, radiotherapy is added for adverse features, and a node burden of four or more positive axillary nodes is the classic trigger. That statement holds true.
Step 2: On endocrine therapy, tamoxifen retains efficacy across the menopausal divide for receptor-positive tumours and is in fact the preferred endocrine agent in premenopausal patients, so claiming it is useless after menopause is incorrect.
Step 3: Aromatase inhibitors depend on peripheral aromatisation of androgens, the dominant estrogen route once the ovaries quiet down; thus they belong to post-menopausal therapy and do not replace tamoxifen in premenopausal women.
Step 4: Regarding chemotherapy, premenopausal women receiving adjuvant systemic treatment are typically given multidrug regimens rather than reserving it for a narrow selected subset. The only fully accurate statement is the four-node radiotherapy rule.
\[\boxed{\text{Post-mastectomy RT when} \geq 4 \text{ nodes positive}}\]