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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

dosimetrist. They will plan the best dose, number and

shape of radiation beams, and number of treatments.

Your plan will be designed to treat the cancer while

sparing normal tissue. Special efforts will be made to

avoid or lessen radiation to the lungs and heart.

Set-up session

Once your treatment plan is made, a set-up session

is needed. This session is sometimes called “port

film” day or dress rehearsal. The set-up session

occurs in the treatment room.

The radiation therapists will help place you in the

correct position on the treatment table. Setup marks

are used for positioning. X-rays of the treatment

fields will be taken and viewed by your doctor. These

x-rays (or port films) are not for treatment. Your

doctor will approve treatment when your setup is


Treatment sessions

Treatment is given once a day on Monday through

Friday for about 5 to 6½ weeks. Each session can

take between 15 to 30 minutes. In general, treatment

is received at the same time each day.

Before treatment, you will be placed into the correct

position. You will lie on top of the breast board that

is on the treatment table. You must be in the same

position that was approved at the setup session.

Conformal techniques are used for breast cancer.

These techniques shape the radiation dose to the

cancer site to spare healthy tissue. 3D-CRT (










herapy) delivers,

from different angles, a photon beam that matches

the shape of the tumor. IMRT (








herapy) is a form of 3D-CRT that further

modifies the beam’s intensity during treatment.

Besides radiation setup techniques, other methods

may be used to spare normal tissue. One method

may include holding your breath during treatment.

This is called “breath-hold.” Respiratory gating is also

a technique that can be performed to spare normal

tissue. The goal is to move your heart away from the


During treatment, you will be alone in the room. A

therapist will operate the machine from a nearby

room. He or she will be able to see, hear, and speak

with you at all times. As treatment is given, you may

hear noises. The machine will move around you to

different treatment angles. You will not see, hear, or

feel the radiation.


Radiation therapy

What to expect