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61

NCCN Guidelines for Patients

®

Breast Cancer - Early-Stage

(STAGES I AND II)

, Version 1.2016

5

Radiation therapy

Treatment options after mastectomy

Chart 5.2

lists options for radiation therapy after

having a mastectomy. If your axillary lymph nodes are

cancer-free, radiation therapy is advised based on

the chances of the cancer returning after treatment.

Breast cancer is more likely to return the larger a

breast tumor is and the smaller a cancer-free surgical

margin is. Despite cancer-free nodes, your doctor

may advise radiation therapy if the surgical margin is

smaller than 1 mm, the breast tumor is larger than 5

cm, or there’s cancer in the surgical margin. Possible

radiation sites are shown in

Figure 5.2

.

When cancer is found in 1 to 3 axillary lymph nodes,

you may receive radiation therapy to multiple sites.

These sites include the chest wall; supraclavicular,

infraclavicular, and axillary areas; and the internal

mammary lymph nodes.

If cancer is in 4 or more axillary lymph nodes, the

breast cancer is upstaged to stage III. Radiation

therapy is advised. Radiation sites include the chest

wall; supraclavicular, infraclavicular, and axillary

areas; and the internal mammary lymph nodes.

Figure 5.2 Radiation after mastectomy

Radiation therapy after mastectomy is based on how likely the cancer will return. The

chest wall behind the removed breast may be radiated. Other sites include areas near

the collarbone and armpit as well as lymph nodes along the breastbone.

supraclavicular area

infraclavicular area

axillary area

internal mammary

lymph nodes

chest wall