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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017





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.

Nipple replacement

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.