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
The course of papillary carcinoma of the thyroid is best described by which of the following statements? 
Select and explain. 
A. Metastases are rare; local growth is rapid; erosion into the trachea and large blood vessels is frequent, B. Local invasion and metastases almost never occur, which makes the term carcinoma misleading, C. Bony metastases are frequent and produce an osteolytic pattern particularly in vertebrae, D. Metastases frequently occur to cervical lymph nodes; distant metastases and local invasion are rare
D: Metastases frequently occur to cervical lymph nodes; distant metastases and local invasion are rare
Answer: D: Metastases frequently occur to cervical lymph nodes; distant metastases and local invasion are rare 
Explanation: Papillary carcinoma of the thyroid frequently metastasizes to cervical lymph nodes, but distant metastasis is uncommon. The nonaggressive nature of this tumor locally and the infrequency of distant metastases combine to produce an 80-95% 5-year survival rate. A contributing factor to the success of thyroid surgery for papillary carcinoma is the easy accessibility of cervical nodes for examination and dissection. Slow growth and a predilection for local extension are characteristics of this tumor that contribute to a high survival rate in affected persons. This is true even of patients who have limited surgery, which has led to considerable controversy regarding the extent of the indicated surgical procedure.