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60

NCCN Guidelines for Patients

®

Breast Cancer - Early-Stage

(STAGES I AND II)

, Version 1.2016

5

Radiation therapy

Treatment options after mastectomy

Treatment options after mastectomy

Chart 5.2 Radiation guide

Results of surgery

Where do I need radiation?

• No cancer in axillary lymph nodes,

• Breast tumor is 5 cm or smaller, and

• No cancer cells near edge of surgical margin

that is 1 mm or larger

• No radiation therapy is needed.

• No cancer in axillary lymph nodes,

• Breast tumor is 5 cm or smaller, and

• No cancer cells near edge of surgical margin

that is smaller than 1 mm

• Consider treating the chest wall.

• No cancer in axillary lymph nodes, and

• Breast tumor is larger than 5 cm or there are

cancer cells at edge of surgical margin

• Strongly consider treating the chest wall ± these sites:

o

Axillary sites at risk for cancer,

o

Supraclavicular and infraclavicular areas, and

o

Internal mammary lymph nodes.

• Cancer in 1 to 3 axillary lymph nodes

• Strongly consider treating the chest wall + these sites:

o

Axillary sites at risk for cancer,

o

Supraclavicular and infraclavicular areas

, and

o

Internal mammary lymph nodes.

• Cancer in 4 or more axillary lymph nodes

• The chest wall,

• Axillary sites at risk for cancer,

Supraclavicular and infraclavicular areas

, and

• Internal mammary lymph nodes.