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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017


Treatment planning

Genetic counseling


Fertility counseling

Genetic counseling

Hereditary breast cancer is caused by abnormal

genes that were passed down from a parent to a

child. Your disease or family history may suggest

you have hereditary breast cancer. In this case,

your doctor will refer you for genetic counseling. A

genetic counselor is an expert in gene mutations that

are related to disease. Your counselor can tell you

more about your chances of having hereditary breast


Your genetics counselor may suggest that you

undergo genetic testing.





mutations that are related to breast cancer are well-

known. Other genes may be tested as well. These

genes may cause cancers other than just breast

cancer. Your counselor will explain what your test

results mean and what action is needed.

Findings of gene mutations may impact your

cancer care. Your test results may be used to

guide treatment planning. Read Part 4 to learn how

hereditary breast cancer may affect your options for

breast surgery. Also, you may need to be watched

more closely if your chances for another cancer

type is high. Your family may also need to undergo

testing, too.

Some genetic test results are called VUS (


ariants of




ignificance). They are not fully understood

by doctors. Also, they do not impact your treatment.

Your doctors may know of research that aims to learn

more. If interested, ask your doctors about taking

part in such research.

Fertility counseling

If you still have menstrual periods, your doctors will

have important information to share with you. First,

it is important that you do not get pregnant during

most cancer treatments. Cancer treatments may

harm your baby. Your doctors can tell you which birth

control methods are best to use while going through


Second, some cancer treatments may affect your

ability to have babies in the future. After treatment

has ended, some women decide they want to have

another baby. If you want to have babies after

treatment or are unsure, tell your doctors.

It may help to talk with a fertility specialist before

you begin cancer treatment. A fertility specialist is an

expert in helping women get pregnant. The fertility

specialist can discuss with you ways to help you

have a baby after treatment.