This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
TNM staging of breast carcinoma with positive bilateral supraclavicular lymph nodes is? 
Select and explain. 
A. N3a, B. N3b, C. N3c, D. M1
D: M1
Answer: D: M1 
Explanation: Answer- D. M1