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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

Sentinel lymph nodes are the first nodes to which

lymph travels after leaving the breast. An SLNB









iopsy) is advised in two

cases. It is advised if the axillary ultrasound

looks okay. It is advised if there’s no cancer in

the biopsy samples. SLNB can be done before or

after preoperative treatment. Read Part 4 for more


Cancer lab tests

The samples are sent to a pathologist to confirm if

cancer is present. A pathologist is a doctor who’s an

expert in testing cells to find disease. You may have

had biopsies of a tumor in your breast, lymph node,

or both sites.

Pathology report

All biopsy results are recorded in a pathology report.

A report will be written each time tissue is removed

from your body and tested for cancer. These reports

are vital to planning treatment.

It’s a good idea to get a copy of your pathology

report(s). Review your report(s) with your doctor.

Take notes. Ask questions if you don’t understand.

This information can be complex.

Histologic typing

The pathologist will examine the samples using a

microscope. If cancer is present, he or she will study

the parts of the cancer cells to classify the disease.

This is called histologic typing. The pathology

report will state if the cancer started in the breast or


If breast cancer is found, the subtype will be noted

in the report. The most common subtype is ductal

breast cancer. Out of every 100 breast cancers,

about 85 to 90 are ductal cancers. These cancers

started in the breast ducts. Breast cancer can also

start in the lobules. These cancers are called lobular

breast cancer. There are other less common types of

breast cancer as well.

Figure 7

Lymph node biopsies

Breast cancer can spread to the

lymph nodes by your armpit.

Signs of cancer in lymph nodes

can be found with a physical

exam, imaging test, or both. If

a test suggests there’s cancer,

a biopsy is needed. An FNA

removes a small group of

cells and a core needle biopsy

removes a solid tissue sample.

Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved.


Treatment planning

Cancer lab tests