NCCN Guidelines for Patients
Breast Cancer – Locally Advanced (STAGE III)
Another type of breast reconstruction uses tissue
from your body, known as “flaps.” Tissue from the
belly area, butt, or from under the shoulder blade
is used. Some flaps are completely removed from
your body and then sewn in place. Other flaps stay
attached and then are slid over and sewn into place.
Some risks of flaps are tissue death, lumps from
death of fat cells, and muscle weakness that may
cause organs to extend through (hernia).
Radiation therapy can affect flaps. Delayed
reconstruction after radiation therapy is advised.
Otherwise, an expander can be placed during
cancer surgery followed by flap reconstruction after
Implants and flaps
Some breasts are reconstructed with both implants
and flaps. Using both may give the reconstructed
breast more volume and help match its shape to your
other breast. However, for any reconstruction, you
may need surgery on your real breast to match both
breasts in size and shape.
You can have your nipple remade, use a fake nipple,
or do nothing. The plastic surgeon can recreate
a nipple mound with the surrounding tissues.
Sometimes, tissue can be moved from other parts of
your body. These other parts include your thigh, other
nipple, or female parts between your legs (vulva).
You may lose feeling in your real nipple if tissue is
removed. Tissue used from other areas of your body
to make a nipple can be darkened in color with a
Surgery is a key part of treatment for stage
III breast cancer. A lumpectomy removes the
tumor and a rim of healthy tissue around it. A
total mastectomy removes the whole breast but
no chest muscle.
Sentinel lymph node biopsy removes the lymph
nodes to which breast cancer first spreads.
Axillary lymph node dissection removes sentinel
and other nodes near the armpit.
Many women with stage III breast cancer
receive a mastectomy and axillary lymph node
dissection. If certain conditions are met, a
lumpectomy may be an option.
Volume displacement is the shifting of the
remaining breast tissue so as to fill the hole left
by the lumpectomy.
Breast reconstruction after mastectomy is done
with breast implants, flaps, or both.