Given below are two statements. One is labelled as Assertion (A) and other as Reason (R).
Assertion (A): Metastasis of breast carcinoma is found in axillary lymph nodes.
Reason (R): Cancer cell have property to travel through Lymphatics.
Select the correct answer using the code given below:

1. A

   Both (A) and (R) are true and (R) is the correct explanation of (A)

2. B

   Both (A) and (R) are true but (R) is not a correct explanation of (A)

3. C

   (A) is true, but (R) is false

4. D

   (A) is false, but (R) is true

Appeared in: UPPSC 2022

Explanation

• Assertion (A) is correct because the axillary lymph nodes are the primary site for lymphatic drainage from the breast, receiving about 75% of the lymph.
• Reason (R) is also correct as the ability to invade and travel through lymphatic vessels (lymphatic spread) is a key characteristic of cancer cells, especially carcinomas.
• The reason correctly explains the assertion: The inherent ability of cancer cells to travel via lymphatics, combined with the breast's natural drainage pathway to the axilla, results in metastasis to the axillary lymph nodes.

Why Other Options Were Wrong

• Option B: This is incorrect because the reason directly explains the assertion. The ability of cancer cells to travel via lymphatics is the precise mechanism for their spread to the draining lymph nodes.
• Option C: This is incorrect because Reason (R) is a fundamental principle in oncology. Lymphatic spread is a major and common pathway for cancer metastasis, particularly for carcinomas.
• Option D: This is incorrect because Assertion (A) is a well-established clinical fact. The axillary lymph nodes are the most common site of regional metastasis from breast cancer due to the breast's lymphatic anatomy.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Assertion and Reason: Breast Cancer Metastasis as background academic context rather than a clinical decision trigger.
• Assessing the axillary lymph nodes is a critical part of staging breast cancer. The presence and number of involved nodes (nodal status) is a powerful prognostic factor and guides treatment decisions, such as the need for chemotherapy or radiation.
• The concept of a 'sentinel lymph node'—the first node to receive drainage from a tumor—is used to minimize surgical morbidity. A biopsy of this node can determine if cancer has spread, avoiding a full axillary dissection if it's negative.
• What if? If a breast tumor is located in the inner quadrant of the breast, the primary lymphatic drainage might be to the parasternal (internal mammary) nodes instead of, or in addition to, the axillary nodes. This changes the pattern of metastasis and may require different radiation fields.

How to Approach the Question

• This is an Assertion-Reason question. The goal is to evaluate two statements and their relationship.
• Step 1: Evaluate the Assertion. Is it a true statement? Recall or deduce that breast cancer commonly spreads to the nearby axillary lymph nodes. So, Assertion (A) is true.
• Step 2: Evaluate the Reason. Is it a true statement? Recall the basic mechanisms of cancer spread. The ability to travel through blood and lymph vessels is a hallmark of metastasis. So, Reason (R) is true.
• Step 3: Evaluate the link. Does the Reason explain the Assertion? Ask 'Why does breast cancer metastasize to axillary nodes?' The answer is 'Because cancer cells can travel through lymphatics, and the breast's lymphatics drain to the axilla.' Since the Reason is part of this explanation, (R) is the correct explanation of (A).
• Step 4: Select the option that matches your conclusion: Both are true, and R is the correct explanation of A.

Concept Tested & Keywords

• Concept Tested: Assertion and Reason: Breast Cancer Metastasis
• Stem keywords: Metastasis, breast carcinoma, axillary lymph nodes, Cancer cell, Lymphatics
• Lead-in keywords: Assertion (A), Reason (R)

Question ID

QuHN-PF_quxgckLgyfO9Jh

Copy ID

Reference Book

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 282-284

E6 Anatomy Applied Ashalatha 4e p. 396-398