NCCN Guidelines for Patients
Breast Cancer – Locally Advanced (STAGE III)
Breast cancer may return after a cancer-
free period. Part 8 reviews treatment for
cancer that returns in a breast or nearby
sites. If distant sites have cancer, read theNCCN Guidelines for Patients®: Breast Cancer – Metastatic (STAGE IV) .
lists the tests that are used to tailor your
treatment to you. Many were described in Part 2.
Such tests include a medical history, physical exam,
and imaging and blood tests. If not received before,
genetic counseling is advised if you may have
hereditary breast cancer.
In addition to the tests in Part 2, other tests may be
needed for a recurrence. A biopsy of the recurrence
site is advised to confirm it is cancer. The methods
for the biopsy depend on the site. The imaging tests
described next may also be needed.
Breast cancer can spread to your spine or brain.
Cancer spread to the brain is much less common
than to the spine. MRI is advised if your symptoms
suggest cancer is present. Contrast will be used.
X-rays of bones that hurt are advised. Long and
weight-bearing bones that aren’t normal on bone
scan or PET/CT and may fracture should also be
Guide 13. Health care before treatment
Main tests and services
Other care that may be useful
Spine MRI with contrast if certain symptoms appear
Brain MRI with contrast if certain symptoms appear
Complete blood count
X-rays of bones that hurt
Comprehensive metabolic panel
X-rays of long or weight-bearing bones that are
abnormal on bone scan
Chest diagnostic CT scan with contrast
Abdomen ± pelvis diagnostic scans (CT or MRI with
Bone scan or sodium fluoride PET/CT
FDG PET/CT sometimes
Hormone receptor test on cancer cells
HER2 test on cancer cells
Genetic counseling if you may have hereditary