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NCCN Guidelines for Patients



Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

Treatment guide

Some treatment options for recurrences are

explained in this section. They are grouped by where

the recurrence is in your body. A local recurrence

is breast cancer that returned within a breast or the

chest wall. A regional recurrence is breast cancer

that returned in nearby lymph nodes.

This section includes “systemic” treatment as an

option. Doctors use this term when talking about

a cancer treatment for the whole body. Systemic

treatment includes chemotherapy, chemotherapy

with HER2 antibodies, and endocrine therapy.

Local recurrence

Guide 14

lists the treatment options for a local

recurrence. Options are based on your prior


If you had breast-conserving therapy, a total

mastectomy is advised. You may also have an

axillary lymph node dissection. Systemic treatment

may be part of your treatment, too.

If you had only a mastectomy, you may have surgery

to remove the cancer. Afterward, radiation therapy

is advised. Radiation sites include the chest wall

and lymph nodes around your collarbone. Systemic

treatment may be added.

You may have had a mastectomy, axillary lymph

node dissection, and radiation therapy. In this case,

the cancer should be removed by surgery if possible.

Systemic treatment may be added.



Treatment guide

Guide 14. Options for local recurrence

Prior treatment

What treatment should I have?

Breast-conserving therapy


• Total mastectomy

• Axillary lymph node dissection

• Consider systemic treatment

Total mastectomy


• Surgery if possible

• Radiation therapy

• Consider systemic treatment

Total mastectomy with axillary

lymph node dissection and

radiation therapy


• Surgery if possible

• Consider systemic treatment