Radiation Therapy (WBI Versus PBI) in Treating Women Who Have Undergone Surgery For Ductal Carcinoma In Situ or Stage I or Stage II Breast Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed ductal carcinoma in situ (DCIS\*) or invasive\* adenocarcinoma of the breast
• * Stage 0, I, or II disease
• * Stage II tumors must be ≤ 3 cm
• * Gross disease must be unifocal
• * Microscopic multifocality allowed provided total pathological tumor size is ≤ 3 cm
• * No proven multicentric carcinoma in more than 1 quadrant or separated by ≥ 4 cm
• * No non-epithelial breast malignancies (e.g., sarcoma or lymphoma) NOTE: \*Patients who are 50 years of age and over with DCIS regardless of hormone receptor status AND patients with invasive breast cancer meeting all of the following criteria: ≥ 50 years of age, node-negative, and hormone-receptor positive status will not be enrolled in study after 12/30/2006
• Prior axillary staging required for patients with invasive breast cancer, including 1 of the following:
• * Sentinel node biopsy alone (if sentinel node is negative)
• * Sentinel node biopsy followed by axillary dissection or sampling with ≥ 6 axillary nodes (if sentinel node is positive)
• * Axillary dissection alone with ≥ 6 axillary nodes
• No more than 3 positive axillary nodes
• * No axillary nodes with definite evidence of microscopic or macroscopic extracapsular extension
• * No positive non-axillary sentinel nodes (intramammary nodes are staged as axillary nodes)
• * No palpable or radiographically suspicious ipsilateral or contralateral axillary, supraclavicular, infraclavicular, or internal mammary nodes unless there is histologic confirmation that these nodes are negative for tumor
• Must have undergone lumpectomy
• * Resected margins histologically free of tumor
• * Re-excision of surgical margins allowed
• * Target lumpectomy cavity clearly delineated AND target lumpectomy/whole breast reference volume ≤ 30% based on postoperative pre-randomization CT scan
• * Final surgery (i.e., lumpectomy, re-excision of margins, or axillary staging procedure) within the past 42 days
• No suspicious microcalcifications, densities, or palpable abnormalities in the ipsilateral or contralateral breast unless biopsied and found to be benign
• No Paget's disease of the nipple
• No history of invasive breast cancer or DCIS
• * Prior lobular carcinoma in situ treated by surgery alone allowed
• No synchronous bilateral invasive or non-invasive breast cancer
• Partial breast irradiation deemed technically deliverable by radiation oncologist at a credentialed facility
• Must have undergone a history and physical exam within the past 4 months AND a bilateral mammogram within the past 6 months
• Hormone receptor status:
• * Estrogen receptor (ER) status known
• * Progesterone status known if ER analysis is negative
• * Marginal or borderline results are considered positive
• PATIENT CHARACTERISTICS:
• Age
• 18 and over
• Sex
• Female
• Menopausal status
• Premenopausal or postmenopausal
• Performance status
• Not specified
• Life expectancy
• At least 10 years, excluding diagnosis of breast cancer
• Hematopoietic
• Not specified
• Hepatic
• Not specified
• Renal
• Not specified
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective non-hormonal contraception
• No other malignancy within the past 5 years except previously treated carcinoma in situ of the cervix or colon, melanoma in situ, or basal cell or squamous cell skin cancer
• * Deemed to be at low risk for recurrence
• No collagen vascular disease (e.g., systemic lupus erythematosus or scleroderma), specifically dermatomyositis with a creatine phosphokinase (CPK) level above normal, or active skin rash
• No psychiatric or addictive disorder that would preclude study therapy
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• No prior biologic therapy for this malignancy
• Chemotherapy
• No prior chemotherapy for this malignancy
• No concurrent chemotherapy during study radiotherapy
• Endocrine therapy
• No prior hormonal therapy for this malignancy unless total duration of hormonal therapy was no more than 28 days before randomization
• Concurrent hormonal therapy allowed provided it is not administered during chemotherapy
• No concurrent raloxifene, tamoxifen, or other selective estrogen receptor modulating drugs
• No concurrent hormone replacement therapy
• No concurrent Femring\^®
• Radiotherapy
• No prior radiotherapy for this malignancy
• No prior breast or thoracic radiotherapy
• No concurrent brachytherapy boosts
• No concurrent intensity modulated radiotherapy
• No concurrent regional nodal irradiation
• Surgery
• See Disease Characteristics
• No prior breast implants
• * Patients who have had implants removed are eligible
• Other
• No other concurrent anticancer therapy