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47

NCCN Guidelines for Patients

®

:

Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

5

Radiation therapy

Treatment guide

Guide 8. Options for clinical stage IIIA (T0–T3, N2, M0), IIIB, IIIC

Breast surgery

Where is radiation needed?

Lumpectomy

ª

• Whole breast ± boost to surgical site

• Infraclavicular and supraclavicular areas

• Internal mammary lymph nodes

• Axillary area at risk for cancer

Mastectomy

ª

• Chest wall ± scar boost

• Infraclavicular and supraclavicular areas

• Internal mammary lymph nodes

• Axillary area at risk for cancer

Guide 7. Options for clinical stage IIIA (T3, N1, M0)

Breast surgery

Highest N stage

Where is radiation needed?

Lumpectomy

pN1

ª

• Whole breast ± boost to surgical site

• Strongly consider treating

◦◦ Infraclavicular and supraclavicular areas

◦◦ Internal mammary lymph nodes

◦◦ Axillary area at risk for cancer

pN2 or pN3

ª

• Whole breast ± boost to surgical site

• Infraclavicular and supraclavicular areas

• Internal mammary lymph nodes

• Axillary area at risk for cancer

Mastectomy

pN1

ª

• Strongly consider treating

◦◦ Chest wall ± scar boost

◦◦ Infraclavicular and supraclavicular areas

◦◦ Internal mammary lymph nodes

◦◦ Axillary area at risk for cancer

pN2 or pN3

ª

• Chest wall ± scar boost

• Infraclavicular and supraclavicular areas

• Internal mammary lymph nodes

• Axillary area at risk for cancer