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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017



Treatment planning

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 the

NCCN Guidelines for Patients®: Breast Cancer – Metastatic (STAGE IV) .

Treatment planning

Guide 13

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

Medical history

Spine MRI with contrast if certain symptoms appear

Physical exam

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

breast cancer