This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Breast, Subject name: Surgery
[{'content': 'In inflammatory carcinoma breast with metastasis to axilla, treatment of choice: \nSelect and explain. \nA. NACT + MRM + Radiotherapy, B. Radical mastectomy plus chemotherapy, C. Radical mastectomy plus radiotherapy, D. Chemotherapy followed by hormone therapy', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Hallmark of inflammatory breast Ca is diffuse tumour involvement of dermal lymphatic channel breast & overlying skin, often without an underlying tumour mass. Presents with inflammatory changes like erythema, edema (peau de orange) warmth as a result of lymphatic obstruction. At least 33% skin over breast involved. History of rapid onset & progression. Inflammatory breast Ca is a clinical diagnosis & can occur with tumour of ductal or lobular histology Inflammatory breast Ca = stage T4d, corresponds to stage IIIB i.e. locally advanced breast Ca. Rx: NACT + MRM + .', 'role': 'assistant'}]