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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

What to expect

For breast cancer, the most common radiation

method is EBRT (









A large machine makes radiation beams used for

treatment. This machine is called a LINAC (





The beams consists of high-energy x-rays, which are

a type of photon radiation. They will move through

your body at the speed of light. There is no ongoing

radiation inside of you after the treatment session.

You will not have to avoid people.

It takes a team of people to perform the radiation

therapy. The radiation team consists of doctors,

medical physicists, dosimetrists, nurses, and

radiation therapists. Your team will work together to

design your treatment plan and provide treatment.

Planning session

A planning session is needed to map out your

treatment. The planning process is called simulation.

It involves obtaining a CT scan. The planning session

takes about one hour.

You will not have to do anything to prepare. It may

be helpful to wear easy-to-remove clothes since

you’ll change into a gown. You will need to remove

necklaces and long earrings.

In the CT room, there will be a table with a breast

board. The breast board is used to keep you in place

during treatment. The radiation therapists will let

you know whether to lie face down or face up on the

table. At least one of your arms will be raised above

your head. Red laser lights are used to help position


Once on the table, thin strips of sticky markers are

often applied to the skin. These markers will be

placed on your scars as well as your breast or chest

wall. Next, a CT scan will be done. The medical

physicist or dosimetrist will take measurements of

your breast.

The CT images will be transferred to a treatment

planning computer. Any remaining breast tumor, the

surgical site, other organs, and the markers can be

seen on the scan. This information will show your

radiation oncologist where to direct the radiation.

This area is called the treatment field.

After the treatment fields are set, your skin will be

marked for treatment sessions. Setup marks are

made with ink or tiny permanent tattoos. Also, photos

of your set up are taken. The marks and photos will

be used to position you for daily treatment sessions.

After simulation, your radiation team will further

plan your treatment. Plans are made viewing your

CT scans on the treatment planning computer.

Your radiation oncologist will work closely with a


Radiation therapy

What to expect