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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017


Treatment planning

Distress screening



Distress screening

Distress is an unpleasant experience of a mental,

physical, social, or spiritual nature. It can affect how

you feel, think, and act. It can include feelings of

sadness, fear, helplessness, worry, anger, guilt, and

so forth. Everyone with cancer has some distress at

some point in time. It is to be expected.

Feeling distressed may be a minor problem or it

may be more serious. You may be so distressed that

you can’t do the things you used to do. Serious or

not, it is important that your treatment team knows

how you feel. They may ask you to complete a list

of screening questions to assess how distressed

you are. Read the

NCCN Guidelines for Patients ® : Distress

to learn more.

If needed, your treatment team can get you help.

Help can include support groups, talk therapy,

or medication. Some people also feel better by

exercising, talking with loved ones, or relaxing. There

may also be helpful community resources, such as

support groups and wellness centers.




A medical history is a report of all health events

in your lifetime. It will include questions about

your family’s health to help assess if you have

hereditary breast cancer.



Your doctor will examine your body for signs of

disease. He or she will touch parts of your body,

including your breasts, to see if anything feels




Imaging tests allow your doctor to see how far

the cancer has spread without cutting into your




Some breast cancers consist of cells with too

many hormone receptors, HER2s, or both.

These features are used to plan treatment.



Blood tests may be done to look for signs of

cancer outside of your breast.



Genetic counseling may help you decide

whether to be tested for hereditary breast




Fertility counseling may be helpful with planning

to have a baby after treatment.



You should be screened for distress so you can

receive help if needed.