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
Lymph node first involved in Ca breast is /are:
(A)Axillary
(B)Internal mammary
(C)Supraclavicular
(D)Contralateral axillary 
Select and explain. 
A. BC, B. CA, C. BC, D. AB
D: AB
Answer: D: AB 
Explanation: Lymphatic Spread in Carcinoma of Breast Occurs through:
• Subareolar Sappey's lymphatic plexus
• Cutaneous lymphatics
• Inflammatory lymphatics  Lymphatic drainage of the breast is predominantly through axillary (75%).
Posterior 1/3 rd of the breast are more likely to drain to the internal mammary nodes 1 ,
Involvement of supradaviular nodes & of any contralateral lymph nodes represents advanced disease