Accelerated Partial Breast Irradiation for Early Breast Cancer

Exclusion Criteria

• •Multifocal or multicentric tumours.
• •Clinical or pathologic evidence of any of the following tumour features: extension to chest wall (excluding pectoralis muscle); oedema (including peau d'orange) or ulceration of skin; satellite skin nodules confined to the same breast; and inflammatory carcinoma.
• •Presence of extensive intraductal component (ductal carcinoma in situ occupying \> 25% of the primary invasive tumour and present adjacent to the primary tumour).
• •Node-positive breast cancer determined by sentinel node biopsy, axillary dissection, or in women \> 70 years of age, clinical examination.
• •Inability to localise surgical cavity on CT scans with no evidence of a surgical cavity, seroma or surgical clips delineating the tumour bed.
• •Treatment target volume estimated to occupy \> 25% of the ipsilateral whole breast volume.
• •Synchronous or metachronous bilateral invasive or intraductal breast cancer.
• •Locally recurrent breast cancer.
• •Ipsilateral breast implant.
• •Serious non-malignant disease that precludes definitive surgical or radiation treatment (e.g. scleroderma, systemic lupus erythematosus, cardiovascular/pulmonary/renal disease).
• •Previous or concomitant malignancies except non-melanoma skin cancer, carcinoma in situ of the cervix, and invasive carcinoma of the colon, thyroid, cervix, or endometrium treated five years prior to study entry.
• •Women who are pregnant or lactating.
• •Psychiatric or addictive disorders that preclude obtaining informed consent or adherence to protocol