3-Dimensional Conformal Radiation Therapy In Treating Women With Stage I or Stage II Breast Cancer Previously Treated With Lumpectomy and Axillary Node Dissection

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed invasive breast cancer
• •* Stage I or II (T1, N0; T1, N1; T2, N0; or T2, N1)
• •* Unifocal disease (single focus that can be encompassed by one lumpectomy)
• •* The following histologies are eligible:
• •* Invasive ductal
• •* Medullary
• •* Papillary
• •* Colloid (mucinous)
• •* Tubular
• •No invasive or extensive in situ lobular carcinoma or pure ductal carcinoma in situ (DCIS)
• •No nonepithelial breast malignancies such as sarcoma or lymphoma
• •Previously treated with lumpectomy of a lesion no greater than 3 cm and axillary dissection of at least 6 lymph nodes or a sentinel node biopsy
• •* Six surgical clips in place delineating the margins of the tylectomy cavity
• •* Negative, inked histologic margins of lumpectomy (greater than 2 mm) OR re-excision specimen available for confirmation
• •* Negative mammography post-lumpectomy or post-excision if malignancy-associated microcalcifications were initially present
• •* No prior lumpectomy so extensive that the cosmetic result is low or poor prior to radiotherapy
• •No more than 3 positive axillary nodes
• •No proven multicentric carcinoma (tumors in different quadrants of the breast or tumor separated by at least 4 cm) with other clinically or radiographically suspicious areas in the ipsilateral breast unless negative by biopsy
• •No palpable or radiographically suspicious contralateral axillary, supraclavicular, infraclavicular, or internal mammary nodes unless nodes are histologically negative
• •No extensive intraductal carcinoma, indicated by one of the following according to the Harvard definition:
• •* More than 25 % of invasive tumor is DCIS and DCIS is in adjacent breast tissue
• •* Intraductal carcinoma with microinvasion
• •No previously treated contralateral breast cancer or synchronous ipsilateral breast cancer
• •No evidence of suspicious microcalcifications
• •No Paget's disease of the nipple
• •No skin involvement by disease, regardless of tumor size
• •No distant metastases
• •Hormone receptor status:
• •* Not specified
• •PATIENT CHARACTERISTICS:
• •Age
• •18 and over
• •Sex
• •Female
• •Menopausal status
• •Not specified
• •Performance status
• •Not specified
• •Life expectancy
• •At least 2 years
• •Hematopoietic
• •Not specified
• •Hepatic
• •Not specified
• •Renal
• •Not specified
• •Other
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •Technically suitable for breast radiotherapy
• •No collagenous diseases (e.g., systemic lupus erythematosus, scleroderma, or dermatomyositis)
• •No other medical condition that would limit life expectancy
• •No psychiatric or addictive disorders that would preclude giving informed consent
• •No other malignancy within the past 5 years except nonmelanoma skin cancer
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •Not specified
• •Chemotherapy
• •At least 2 weeks since prior chemotherapy
• •No concurrent chemotherapy during and for at least 2 weeks after completion of study therapy
• •Endocrine therapy
• •Concurrent anastrozole or tamoxifen allowed
• •Radiotherapy
• •No prior radiotherapy for the current malignancy
• •Surgery
• •See Disease Characteristics
• •Other
• •No prior nonhormonal therapy for the current malignancy