Breast-Conserving Therapy Compared With Mastectomy Followed By Radiation Therapy in Treating Women With Locally Advanced Breast Cancer Previously Treated With Chemotherapy

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically or cytologically confirmed locally advanced breast cancer
• •* T3 inoperable, N0-N2
• •* Any T, N2
• •* T4, N0-N2
• •* Inflammatory breast carcinoma
• •Prior treatment with 4-6 courses of standard induction chemotherapy or active investigational regimens completed within the past 4 weeks
• •Residual tumor size less than 5 cm
• •No fixed axillary lymph nodes
• •No multifocal or bilateral breast cancer
• •No clinical suspicion of extensive ductal carcinoma in situ
• •No unresolved skin edema
• •No distant metastases (including ipsilateral supraclavicular node)
• •* Positive bone scan allowed provided there are no bone metastases on x-ray
• •Hormone receptor status:
• •* Not specified
• •PATIENT CHARACTERISTICS:
• •Age:
• •Any age
• •Sex:
• •Female
• •Menopausal status:
• •Not specified
• •Performance status:
• •WHO 0-1
• •Life expectancy:
• •Not specified
• •Hematopoietic:
• •Neutrophil count at least 2,000/mm\^3
• •Platelet count at least 100,000/mm\^3
• •Hepatic:
• •Bilirubin less than 1.5 times normal
• •SGOT and SGPT no greater than 2 times normal
• •Alkaline phosphatase no greater than 2 times normal
• •Renal:
• •Creatinine less than 1.5 times normal
• •Other:
• •No other prior or concurrent malignancy except adequately treated squamous cell or basal cell skin cancer or adequately treated cone-biopsied carcinoma in situ of the cervix
• •No serious underlying medical illness that would preclude study
• •No psychiatric or addictive disorder that would preclude study
• •No contraindication to study treatment
• •Not pregnant
• •Fertile patients must use effective barrier contraception
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •Not specified
• •Chemotherapy:
• •See Disease Characteristics
• •Endocrine therapy:
• •No concurrent hormonal replacement therapy
• •No concurrent oral contraceptives
• •Radiotherapy:
• •See Disease Characteristics
• •No prior radiotherapy for breast cancer
• •Surgery:
• •No prior surgery for breast cancer other than biopsy for diagnosis confirmation
• •Other:
• •No other prior systemic therapy for breast cancer