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
Most important prognostic factor for breast carcinoma is: 
Select and explain. 
A. Age of the patient, B. Lymph node involvement, C. Genetic factors, D. Family history
B: Lymph node involvement
Answer: B: Lymph node involvement 
Explanation: Ans. (b) Lymph node involvementPrognosis related to lymph node status:* Overall the best prognostic factor for ca breast - disease free survival and overall survival is axillary lymph node status.* But if the question has the choice of staging, then it must be opted because it includes lymph node status & metastasis also.* But the question if asked about the prognosis in metastatic: ca breast- the best option is ER or PR status because the further prognosis and survival in metastatic patients is based on their response to hormone therapy.* The patients with ER positive and more with PR positive will respond well with hormone therapy and have a prolonged survival