NCCN Guidelines for Patients
Breast Cancer – Locally Advanced (STAGE III)
lists the deciding factors for breast
surgeries. If you had preoperative treatment, your
surgical options are based on how well treatment
worked. Another deciding factor is the amount of
breast tissue that needs to be removed.
For any stage III cancer that shrank enough, a
lumpectomy may be an option. However, there
are other factors to consider. The other option is a
A lumpectomy may be an option if only some of
your breast needs to be removed. Removing a
large part may cause your breast to look deformed.
A lumpectomy is not advised when more than one
cut is needed to remove all the cancer. Is it also not
advised if worrisome spots throughout the breast
should be removed with the cancer.
Some deciding factors clearly rule out a lumpectomy.
It isn’t an option if you should not or cannot have
radiation. Do not receive radiation therapy during
pregnancy. Lumpectomy may not be an option if
you’ve had radiation near the tumor site. Some
connective tissue diseases may also exclude
lumpectomy. Examples include scleroderma and
Being likely to get new breast tumors due to your
genes may exclude lumpectomy. Talk with your
doctor about genetic mutations that may affect your
options. Some are discussed next.
Lumpectomy is not advised if both
mutated. Normal ATM protects the body from cells
with damaged DNA. It fixes, shuts down, or kills the
damaged cells. When mutated,
genes can lead
to breast cancer.
mutations also make the side effects of
radiation therapy much worse. New tumors may form
because of the radiation. Thus, breast-conserving
therapy is not advised.
A lumpectomy may not be an option if you have Li-
Fraumeni syndrome. It increases the risk for breast
cancer. Like having an
therapy should also be avoided.
Guide 5. Breast surgery
with radiation therapy
(AKA breast-conserving therapy)
may be an option if all these factors
• Don’t need a large part of your breast removed,
• Aren’t genetically predisposed to breast cancer, AND
• Can have radiation therapy.
may be an option if
any of these factors describe you:
• Are not approved for a lumpectomy,
• A lumpectomy would not remove all the cancer, OR
• Are approved for a lumpectomy but declined.