Options for Stage 3C Operable
Any one of the following is an option:

• Lumpectomy to remove only the cancer and some surrounding breast tissue, followed by lymph node removal and radiation therapy
• Modified radical mastectomy with or without breast reconstructive surgery
• Clinical trials for stage 3C breast cancer

Any one of the following may also be added following surgery:

• Radiation therapy to the lymph nodes and chest wall after a modified mastectomy
• Systemic chemotherapy with or without hormone therapy
• Hormone therapy
• LHRH antagonist therapy instead of surgery to remove ovaries
• Clinical trial of trastuzumab (Herceptin) combined with systemic chemotherapy

Important factors that influence decision making:

• A history of endometrial cancer makes hormone therapy risky.
• A history of stroke, DVT or pulmonary embolism makes tamoxifen therapy more risky.
• A history of vision problems or retinal disease makes tamoxifen therapy more risky.
• Being pregnant limits drug and hormone therapy options.
• Breast feeding limits drug and hormone therapy options.
• Having had your ovaries removed makes hormone therapy unnecessary.
• Having had your uterus removed makes hormone therapy less risky.
• Hormone receptor status: hormone therapy is not an option if the tumor is estrogen receptor negative.
• Hormone therapy can increase the risk of osteoporosis.
• Hormone therapy recipients will need close follow-up to make sure they do not develop uterine cancer.
• The desire to get pregnant makes tamoxifen therapy more risky, because it can cause birth defects.

Options for Stage 3C Inoperable
Any one or more of the following may be an option:

• Systemic chemotherapy (now considered to be the standard of care)
• Hormone therapy if hormone receptor positive
• Women who respond well to chemotherapy may be candidates for lumpectomy to remove only the cancer and some surrounding breast tissue, followed by lymph node removal and radiation therapy
• Women who do not respond well to chemotherapy may be candidates for total mastectomy, followed by lymph node removal and radiation therapy.

Important factors that influence decision making:

• A history of endometrial cancer makes hormone therapy risky.
• A history of stroke, DVT or pulmonary embolism makes tamoxifen therapy more risky.
• A history of vision problems or retinal disease makes tamoxifen therapy more risky.
• Being pregnant limits drug and hormone therapy options.
• Breast feeding limits drug and hormone therapy options.
• Having had your ovaries removed makes hormone therapy unnecessary.
• Having had your uterus removed makes hormone therapy less risky.
• Hormone receptor status: hormone therapy is not an option if the tumor is estrogen receptor negative.
• Hormone therapy can increase the risk of osteoporosis.
• Hormone therapy recipients will need close follow-up to make sure they do not develop uterine cancer.
• The desire to get pregnant makes tamoxifen therapy more risky, because it can cause birth defects.