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
A patient presents with a unilateral ca breast of 4 cm size with skin ulceration involving the nipple. On palpation axillary lymph nodes are positive. Management would involve: 
Select and explain. 
A. Breast conserving procedure, B. Simple mastectomy, C. Modified radical mastectomy, D. Palliative treatment
C: Modified radical mastectomy
Answer: C: Modified radical mastectomy 
Explanation: Here this patient is having Stage III disease (T4, N1 or N2, M0) according to the TNM table given above. Hence the management would be - Neoadjuvant chemotherapy + MRM + adjuvant radiation therapy + chemotherapy + antiestrogen therapy