NCCN VERSION 2 2015

NCCN Guidelines Index

Breast Cancer Table of Contents

Discussion

and this illustration may not be reproduced in any form without the express written permission of NCCN

Note: All recommendations are category 2A unless otherwise indicated.

Clinical Trials: NCCN believes that the best management of any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged.

BINV-G

NCCN Guidelines Version 2.2015

Invasive Breast Cancer

See Margin Status in Infiltrating Carcinoma (BINV-F)

SPECIAL CONSIDERATIONS TO BREAST-CONSERVING THERAPY REQUIRING RADIATION THERAPY

Contraindications for breast-conserving therapy requiring radiation therapy include:

Absolute:

• Radiation therapy during pregnancy

• Diffuse suspicious or malignant-appearing microcalcifications

• Widespread disease that cannot be incorporated by local excision through a single incision that achieves negative margins with a

satisfactory cosmetic result

• Positive pathologic margin

Relative:

• Prior radiation therapy to the chest wall or breast; knowledge of doses and volumes prescribed is essential.

• Active connective tissue disease involving the skin (especially scleroderma and lupus)

• Tumors >5 cm (category 2B)

• Diffusely positive pathologic margins

• Women with a known or suspected genetic predisposition to breast cancer:

May have an increased risk of ipsilateral breast recurrence or contralateral breast cancer with breast-conserving therapy

Prophylactic bilateral mastectomy for risk reduction may be considered.

(See NCCN Guidelines for Breast Cancer Risk Reduction)