OBJECTIVES:
Primary
* Estimate and compare local recurrence-free survival of women with ductal breast carcinoma in situ (DCIS) treated with breast-conserving surgery followed by whole breast irradiation with vs without a radiation tumor bed boost.
Secondary
* Compare relapse-free survival between the two arms.
* Compare overall survival.
* Compare acute and late toxicities.
* Compare cosmetic results and quality of life.
* Identify patients at risk for late toxicities using a biological test.
Tertiary
* Store blood samples at the CEPH (French Center of the Human Polymorphism Center) for polymorphism analyses.
OUTLINE: This is a multicenter study. All patients undergo breast-conserving surgery (after a single intervention or second excision) with a margin ≥ 1 mm. A superficial or deep margin is acceptable if the surgery has left the skin tissue or the fascia pectoral muscle, respectively. Twelve weeks later, patients are randomized to 1 of 2 treatment arms.
* Arm I: Patients undergo whole breast irradiation (WBI) once daily, 5 days a week for 5 weeks.
* Arm II: Patients undergo WBI as in arm I. Patients also undergo a radiation tumor bed boost once daily for 8 fractions (weekdays only) over 2 weeks.
Quality of life will be assessed.
After completion of study treatment, patients are followed up every 6 months for 5 years and then annually for 10 years.
