A 45 year old postmenopausal lady presents with an 8 cm breast lump that is adherent to the skin, with one firm apical lymph node in the axilla and one more node in the ipsilateral supraclavicular area with no clinical evidence of distant metastasis. The staging is
Correct Answer: T4 N3c M0
Description: .TNM Staging Tumour: 1. T1 --Tumour size < 2 cm in greatest diameter. (T1a--0.1-0.5 cm; T1b--0.5-1 cm; T1c--1-2 cm). 2. T2--Size 2-5 cm. 3. T3--Size >5 cm. 4. T4--Tumour fixed to chest wall or skin. (T4a--Fixed to chest wall; T4b--Fixed to skin; T4c--T4a + T4b; T4d--inflammatory carcinoma of breast). Node: N0-- No nodes. N1-- Axillary nodes mobile (ipsilateral). N2-- Axillary nodes fixed to one another and other structures (or only internal mammary lymph nodes are involved but not axillary nodes). N3 -- Supraclavicular nodes. Oedema of arm and internal mammary lymph nodes (ipsilaterally) (or-internal mammary lymph nodes and also axillary lymph nodes are involved). Metastasis: M0 No metastasis. M1 Distant Metastases. ref:SRB&;s manual of surgery,ed 3,pg no 476
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