Standard or Comprehensive Radiation Therapy in Treating Patients With Early-Stage Breast Cancer Previously Treated With Chemotherapy and Surgery
Stage IB Breast Cancer, Stage II Breast Cancer
About this trial
This is an interventional treatment trial for Stage IB Breast Cancer
Eligibility Criteria
Inclusion Criteria:
- The patient must have signed and dated an Institutional Review Board (IRB)-approved consent form that conforms to federal and institutional guidelines
- The patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Patient must have clinically T1-3, N1 breast cancer at the time of diagnosis (before neoadjuvant therapy); clinical axillary nodal involvement can be assessed by palpation, ultrasound, CT scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, or PET/CT scan
- Patient must have had pathologic confirmation of axillary nodal involvement at presentation (before neoadjuvant therapy) based on either a positive fine needle aspirate (FNA) (demonstrating malignant cells) or positive core needle biopsy (demonstrating invasive adenocarcinoma); the FNA or core needle biopsy can be performed either by palpation or by image guidance; documentation of axillary nodal positivity by sentinel node biopsy (before neoadjuvant therapy) is not permitted
- Patients must have had estrogen receptor (ER) analysis performed on the primary breast tumor before neoadjuvant therapy according to current American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guideline recommendations for hormone receptor testing; if negative for ER, assessment of progesterone receptor (PgR) must also be performed according to current ASCO/CAP guideline recommendations for hormone receptor testing (http://www.asco.org)
- Patients must have had HER2 testing performed on the primary breast tumor before neoadjuvant chemotherapy according to the current ASCO/CAP guideline recommendations for human epidermal growth factor receptor 2 testing in Breast Cancer (http://www.asco.org); patients who have a primary tumor that is either HER2-positive or HER2-negative are eligible
- Patient must have completed a minimum of 8 weeks of standard neoadjuvant chemotherapy consisting of an anthracycline and/or taxane-based regimen
- For patients who receive adjuvant chemotherapy after surgery, a maximum of 12 weeks of intended chemotherapy may be administered but must be completed before randomization; (if treatment delays occur, chemotherapy must be completed within 14 weeks); the dose and schedule of the adjuvant chemotherapy are at the investigator's discretion; Note: It is preferred that all intended chemotherapy be administered in the neoadjuvant setting
- Patients with HER2-positive tumors must have received neoadjuvant anti-HER2 therapy (either with all or with a portion of the neoadjuvant chemotherapy regimen), unless medically contraindicated
At the time of definitive surgery, all removed axillary nodes must be histologically free from cancer; acceptable procedures for assessment of axillary nodal status at the time of surgery include:
- Axillary node dissection
- Sentinel node biopsy alone or
- Sentinel node biopsy followed by axillary node dissection
- Note: Patients are eligible whether there is residual invasive carcinoma in the surgical breast specimen or whether there is evidence of pathologic complete response; patients who are found to be pathologically node-positive at the time of surgery, based on sentinel node biopsy alone, are candidates for A011202, a study developed by the Alliance in Oncology, an NCI Cooperative Group; if A011202 is open at the investigator's institution, patients should be approached about participating in the A011202 study
- Patients with pathologic staging of ypN0(i+) or ypN0(mol+) are eligible (Note: Postneoadjuvant therapy is designated with a "yp" prefix.)
- Patient who have undergone either a total mastectomy or a lumpectomy are eligible
- For patients who undergo lumpectomy, the margins of the resected specimen or re-excision must be histologically free of invasive tumor and DCIS as determined by the local pathologist; additional operative procedures may be performed to obtain clear margins; if tumor is still present at the resected margin after re-excision(s), the patient must undergo total mastectomy to be eligible; (patients with margins positive for lobular carcinoma in situ [LCIS] are eligible without additional resection)
- For patients who undergo mastectomy, the margins must be histologically free of residual (microscopic or gross) tumor
- The interval between the last surgery for breast cancer (including re-excision of margins) and randomization must be no more than 70 days; also, if adjuvant chemotherapy was administered, the interval between the last chemotherapy treatment and randomization must be no more than 70 days
- The patient must have recovered from surgery with the incision completely healed and no signs of infection
- If adjuvant chemotherapy was administered, chemotherapy-related toxicity that may interfere with delivery of radiation therapy should have resolved
Exclusion Criteria:
- Definitive clinical or radiologic evidence of metastatic disease
- T4 tumors including inflammatory breast cancer
- Documentation of axillary nodal positivity before neoadjuvant therapy by sentinel node biopsy alone
- N2 or N3 disease detected clinically or by imaging
- Patients with histologically positive axillary nodes post neoadjuvant therapy
- Patients with microscopic positive margins after definitive surgery
- Synchronous or previous contralateral invasive breast cancer or DCIS; (patients with synchronous and/or previous contralateral LCIS are eligible)
- Any prior history, not including the index cancer, of ipsilateral invasive breast cancer or ipsilateral DCIS treated with radiation therapy; (patients with synchronous or previous ipsilateral LCIS are eligible)
- History of non-breast malignancies (except for in situ cancers treated only by local excision and basal cell and squamous cell carcinomas of the skin) within 5 years prior to randomization
- Any radiation therapy for the currently diagnosed breast cancer prior to randomization
- Any continued use of sex hormonal therapy, e.g., birth control pills, ovarian hormone replacement therapy; patients are eligible if these medications are discontinued prior to randomization
- Prior breast or thoracic radiation therapy (RT) for any condition
- Active collagen vascular disease, specifically dermatomyositis with a creatinine phosphokinase (CPK) level above normal or with an active skin rash, systemic lupus erythematosus, or scleroderma
- Pregnancy or lactation at the time of study entry; (Note: Pregnancy testing must be performed within 2 weeks prior to randomization according to institutional standards for women of childbearing potential)
- Other non-malignant systemic disease that would preclude the patient from receiving study treatment or would prevent required follow-up
- Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements
Sites / Locations
- University of Alabama at Birmingham Cancer Center
- University of South Alabama Mitchell Cancer Institute
- Providence Alaska Medical Center
- Arizona Breast Cancer Specialists-Gilbert
- Arizona Center for Cancer Care-Peoria
- Arizona Breast Cancer Specialists-Phoenix
- Arizona Breast Cancer Specialists-Scottsdale
- Arizona Center for Cancer Care-Surprise
- Arizona Oncology Associates-West Orange Grove
- The University of Arizona Medical Center-University Campus
- University of Arkansas for Medical Sciences
- Sutter Cancer Centers Radiation Oncology Services-Auburn
- Mills - Peninsula Hospitals
- Sutter Cancer Centers Radiation Oncology Services-Cameron Park
- Eden Hospital Medical Center
- City of Hope Comprehensive Cancer Center
- Epic Care-Dublin
- Epic Care Partners in Cancer Care
- California Cancer Center - North Fresno
- UC San Diego Moores Cancer Center
- City of Hope Antelope Valley
- Loma Linda University Medical Center
- Los Angeles County-USC Medical Center
- USC / Norris Comprehensive Cancer Center
- Cedars-Sinai Medical Center
- Hoag Memorial Hospital
- Alta Bates Summit Medical Center - Summit Campus
- Kaiser Permanente Oakland-Broadway
- Saint Joseph Hospital - Orange
- UC Irvine Health/Chao Family Comprehensive Cancer Center
- Desert Regional Medical Center
- Huntington Memorial Hospital
- Pomona Valley Hospital Medical Center
- Kaiser Permanente-Rancho Cordova Cancer Center
- Rohnert Park Cancer Center
- Kaiser Permanente-Roseville
- Sutter Cancer Centers Radiation Oncology Services-Roseville
- Sutter Roseville Medical Center
- The Permanente Medical Group-Roseville Radiation Oncology
- Sutter General Hospital
- University of California Davis Comprehensive Cancer Center
- Saint Helena Hospital
- Naval Medical Center -San Diego
- Kaiser Permanente Medical Center - Santa Clara
- City of Hope South Pasadena
- Kaiser Permanente Cancer Treatment Center
- Kaiser Permanente-South San Francisco
- Gene Upshaw Memorial Tahoe Forest Cancer Center
- Sutter Cancer Centers Radiation Oncology Services-Vacaville
- Sutter Solano Medical Center/Cancer Center
- Rocky Mountain Cancer Centers-Aurora
- University of Colorado Cancer Center - Anschutz Cancer Pavilion
- Rocky Mountain Cancer Centers-Boulder
- Penrose-Saint Francis Healthcare
- Memorial Hospital Colorado Springs
- Porter Adventist Hospital
- The Shaw Regional Cancer Center
- Poudre Valley Hospital
- Rocky Mountain Cancer Centers-Littleton
- Saint Mary Corwin Medical Center
- Rocky Mountain Cancer Centers-Thornton
- SCL Health Lutheran Medical Center
- Hartford Hospital
- Middlesex Hospital
- The Hospital of Central Connecticut
- MedStar Georgetown University Hospital
- MedStar Washington Hospital Center
- Sibley Memorial Hospital
- Florida Hospital Cancer Institute Altamonte
- John Fitzgerald Kennedy Medical Center
- Morton Plant Hospital
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
- University of Florida
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
- Jackson Memorial Hospital-Holtz Children's Hospital
- University of Miami Miller School of Medicine-Sylvester Cancer Center
- South Miami Hospital
- Baptist Hospital of Miami
- Florida Hospital Orlando
- UF Cancer Center at Orlando Health
- 21st Century Oncology-Palatka
- Saint Joseph's Hospital/Children's Hospital-Tampa
- Moffitt Cancer Center
- Grady Health System
- Emory University Hospital Midtown
- Piedmont Hospital
- Emory University/Winship Cancer Institute
- Saint Joseph's Hospital of Atlanta
- Tanner Medical Center/Carrollton
- Dekalb Medical Center
- Memorial University Medical Center
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
- The Cancer Center of Hawaii-Leeward
- Queen's Medical Center
- The Cancer Center of Hawaii-Liliha
- Saint Alphonsus Cancer Care Center-Boise
- Kootenai Cancer Center
- Mount Sinai Hospital Medical Center
- Northwestern University
- John H Stroger Jr Hospital of Cook County
- University of Illinois
- University of Chicago Comprehensive Cancer Center
- Advocate Illinois Masonic Medical Center
- Decatur Memorial Hospital
- AMITA Health Alexian Brothers Medical Center
- Elmhurst Memorial Hospital
- NorthShore University HealthSystem-Evanston Hospital
- NorthShore University HealthSystem-Glenbrook Hospital
- Advocate South Suburban Hospital
- NorthShore University HealthSystem-Highland Park Hospital
- Presence Saint Mary's Hospital
- Condell Memorial Hospital
- Loyola University Medical Center
- Edward Hospital/Cancer Center
- UC Comprehensive Cancer Center at Silver Cross
- Advocate Christ Medical Center
- Advocate Lutheran General Hospital
- Illinois CancerCare-Peoria
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
- OSF Saint Francis Medical Center
- Edward Hospital/Cancer Center?Plainfield
- SwedishAmerican Regional Cancer Center/ACT
- Memorial Medical Center
- Carle Cancer Center
- Northwestern Medicine Cancer Center Warrenville
- Saint Vincent Anderson Regional Hospital/Cancer Center
- Parkview Hospital Randallia
- Goshen Center for Cancer Care
- Indiana University/Melvin and Bren Simon Cancer Center
- IU Health Methodist Hospital
- Community Cancer Center East
- Community Cancer Center South
- Franciscan Health Indianapolis
- Community Cancer Center North
- Saint Vincent Hospital and Health Care Center
- Memorial Hospital of South Bend
- Mercy Cancer Center-West Lakes
- Iowa Methodist Medical Center
- Mercy Medical Center - Des Moines
- University of Iowa/Holden Comprehensive Cancer Center
- University of Kansas Cancer Center
- University of Kansas Cancer Center-Overland Park
- Via Christi Regional Medical Center
- Wesley Medical Center
- Wichita NCI Community Oncology Research Program
- Saint Elizabeth Medical Center South
- Saint Elizabeth Fort Thomas
- Norton Hospital Pavilion and Medical Campus
- The James Graham Brown Cancer Center at University of Louisville
- Baptist Health Louisville
- Norton Suburban Hospital and Medical Campus
- Owensboro Health Mitchell Memorial Cancer Center
- Baton Rouge General Medical Center
- Mary Bird Perkins Cancer Center
- Woman's Hospital
- Mary Bird Cancer Center/Saint Tammany Parish
- Mary Bird Perkins Cancer Center/Terrebonne General Medical Center
- Ochsner Medical Center Kenner
- Ochsner Medical Center Jefferson
- Eastern Maine Medical Center
- Maine Medical Center- Scarborough Campus
- Anne Arundel Medical Center
- University of Maryland/Greenebaum Cancer Center
- Greater Baltimore Medical Center
- MedStar Franklin Square Medical Center/Weinberg Cancer Institute
- Johns Hopkins University/Sidney Kimmel Cancer Center
- Upper Chesapeake Medical Center
- Central Maryland Radiation Oncology in Howard County
- Tate Cancer Center
- Boston Medical Center
- Dana-Farber Cancer Institute
- Saint Anne's Hospital
- Lowell General Hospital
- Baystate Medical Center
- University of Michigan Comprehensive Cancer Center
- Henry Ford Cancer Institute¿Downriver
- 21st Century Oncology-Clarkston
- Henry Ford Macomb Hospital-Clinton Township
- Beaumont Hospital-Dearborn
- Wayne State University/Karmanos Cancer Institute
- Henry Ford Hospital
- Saint John Hospital and Medical Center
- Hurley Medical Center
- Genesys Hurley Cancer Institute
- McLaren Cancer Institute-Flint
- Spectrum Health at Butterworth Campus
- Sparrow Hospital
- McLaren Cancer Institute-Lapeer Region
- McLaren Cancer Institute-Macomb
- McLaren Cancer Institute-Central Michigan
- Mercy Health Mercy Campus
- Assarian Cancer Center
- McLaren Cancer Institute-Owosso
- McLaren Cancer Institute-Northern Michigan
- Saint Joseph Mercy Oakland
- William Beaumont Hospital-Royal Oak
- Providence Hospital-Southfield Cancer Center
- 21st Century Oncology-Troy
- William Beaumont Hospital - Troy
- Saint John Macomb-Oakland Hospital
- Henry Ford West Bloomfield Hospital
- Metro Health Hospital
- Mayo Clinic Health System in Albert Lea
- Fairview Ridges Hospital
- Unity Hospital
- Mayo Clinic Health Systems-Mankato
- Abbott-Northwestern Hospital
- Mayo Clinic Radiation Therapy-Northfield
- Mayo Clinic
- Coborn Cancer Center at Saint Cloud Hospital
- Park Nicollet Clinic - Saint Louis Park
- Regions Hospital
- United Hospital
- Ridgeview Medical Center
- University of Mississippi Medical Center
- Baptist Memorial Hospital-Desoto
- Saint Francis Medical Center
- Saint Luke's Hospital
- University of Missouri - Ellis Fischel
- Barnes-Jewish West County Hospital
- Saint Luke's Hospital of Kansas City
- North Kansas City Hospital
- The University of Kansas Cancer Center-South
- Research Medical Center
- The University of Kansas Cancer Center-North
- The University of Kansas Cancer Center-Lee's Summit
- Saint Luke's East - Lee's Summit
- Washington University School of Medicine
- Saint Anthony's Medical Center
- Siteman Cancer Center-South County
- Missouri Baptist Medical Center
- Siteman Cancer Center - Saint Peters
- Billings Clinic Cancer Center
- Benefis Healthcare- Sletten Cancer Institute
- Kalispell Regional Medical Center
- CHI Health Saint Francis
- Alegent Health Bergan Mercy Medical Center
- Alegent Health Lakeside Hospital
- University of Nebraska Medical Center
- Radiation Oncology Centers of Nevada Central
- Renown Regional Medical Center
- Concord Hospital
- Dartmouth Hitchcock Medical Center
- Elliot Hospital
- Memorial Sloan Kettering Cancer Center at Basking Ridge
- Ocean Medical Center
- Cooper Hospital University Medical Center
- Englewood Hospital and Medical Center
- Saint Barnabas Medical Center
- Virtua Memorial
- Jersey Shore Medical Center
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
- The Valley Hospital-Luckow Pavilion
- Capital Health Medical Center-Hopewell
- Riverview Medical Center/Booker Cancer Center
- Valley Hospital
- Robert Wood Johnson University Hospital Somerset
- Sparta Cancer Treatment Center
- MD Anderson Cancer Center at Cooper-Voorhees
- Virtua Voorhees
- Valley Health System-Hematology/Oncology
- University of New Mexico Cancer Center
- Lovelace Radiation Oncology
- New Mexico Oncology Hematology Consultants
- Memorial Medical Center - Las Cruces
- Christus Saint Vincent Regional Cancer Center
- Montefiore Medical Center - Moses Campus
- New York-Presbyterian/Brooklyn Methodist Hospital
- Maimonides Medical Center
- Putnam Hospital Center
- Memorial Sloan Kettering Commack
- Mary Imogene Bassett Hospital
- Vassar Brothers Fishkill Radiation Oncology Center
- Memorial Sloan Kettering Westchester
- Ulster Radiation Oncology Center
- Columbia University/Herbert Irving Cancer Center
- Memorial Sloan-Kettering Cancer Center
- Vassar Brothers Medical Center
- Rochester General Hospital
- Pluta Cancer Center
- Memorial Sloan Kettering Rockville Centre
- Memorial Sloan Kettering Sleepy Hollow
- State University of New York Upstate Medical University
- Carolinas Medical Center/Levine Cancer Institute
- Novant Health Presbyterian Medical Center
- Carolinas Medical Center/Levine Cancer Institute-Pineville
- Carolinas Medical Center/Levine Cancer Institute-University
- Carolinas HealthCare System NorthEast
- Duke University Medical Center
- CaroMont Regional Medical Center
- Cone Health Cancer Center
- East Carolina University
- Matthews Radiation Oncology Center
- Carolinas HealthCare System Union
- South Atlantic Radiation Oncology
- Coastal Carolina Radiation Oncology
- Sanford Bismarck Medical Center
- Summa Akron City Hospital/Cooper Cancer Center
- Akron General Medical Center
- Summa Barberton Hospital
- UHHS-Chagrin Highlands Medical Center
- Aultman Health Foundation
- Geaugra Hospital
- University of Cincinnati/Barrett Cancer Center
- Good Samaritan Hospital - Cincinnati
- Bethesda North Hospital
- Case Western Reserve University
- Cleveland Clinic Cancer Center/Fairview Hospital
- Cleveland Clinic Foundation
- Ohio State University Comprehensive Cancer Center
- The Mark H Zangmeister Center
- Mount Carmel Health Center West
- Delaware Radiation Oncology
- Cleveland Clinic Cancer Center Independence
- Hillcrest Hospital Cancer Center
- Summa Health Center at Lake Medina
- Lake University Ireland Cancer Center
- Southwest General Health Center Ireland Cancer Center
- University Hospitals Parma Medical Center
- North Coast Cancer Care
- Cleveland Clinic Cancer Center Strongsville
- University Pointe
- UHHS-Westlake Medical Center
- Cleveland Clinic Wooster Family Health and Surgery Center
- Cancer Centers of Southwest Oklahoma Research
- University of Oklahoma Health Sciences Center
- Mercy Hospital Oklahoma City
- Willamette Valley Cancer Center
- Compass Oncology Rose Quarter
- Kaiser Permanente Northwest
- Mid-Columbia Medical Center/Celilo Cancer Center
- Lehigh Valley Hospital-Cedar Crest
- UPMC-Heritage Valley Health System Beaver
- Saint Luke's University Hospital-Bethlehem Campus
- Northeast Radiation Oncology Center
- Ephrata Cancer Center
- The Regional Cancer Center
- Fox Chase Cancer Center Buckingham
- Adams Cancer Center
- UPMC Cancer Centers - Arnold Palmer Pavilion
- PinnacleHealth Cancer Center-Community Campus
- Penn State Milton S Hershey Medical Center
- Lancaster General Hospital
- Holy Redeemer Hospital and Medical Center
- Intercommunity Cancer Center
- UPMC-Coraopolis/Heritage Valley Radiation Oncology
- Allegheny Valley Hospital
- University of Pennsylvania/Abramson Cancer Center
- Pennsylvania Hospital
- Thomas Jefferson University Hospital
- Fox Chase Cancer Center
- Temple University Hospital
- Allegheny General Hospital
- UPMC-Magee Womens Hospital
- UPMC-Saint Margaret
- UPMC-Shadyside Hospital
- Reading Hospital
- Wexford Health and Wellness Pavilion
- WellSpan Health-York Hospital
- Rhode Island Hospital
- Radiation Oncology Associates Incorporated
- Women and Infants Hospital
- Kent County Hospital
- Roper Hospital
- Bon Secours Saint Francis Hospital
- Medical University of South Carolina
- Georgetown Hospital System
- Greenville Health System Cancer Institute-Andrews
- Greenville Health System Cancer Institute-Faris
- Saint Francis Cancer Center
- Greenville Health System Cancer Institute-Eastside
- Greenville Health System Cancer Institute-Greer
- Gibbs Cancer Center-Pelham
- The Radiation Oncology Center-Hilton Head/Bluffton
- Greenville Health System Cancer Institute-Seneca
- Spartanburg Medical Center
- Greenville Health System Cancer Institute-Spartanburg
- Lexington Medical Center
- Avera Cancer Institute
- Sanford USD Medical Center - Sioux Falls
- The West Clinic - Wolf River
- Thompson Cancer Survival Center
- Baptist Memorial Hospital and Cancer Center-Memphis
- Vanderbilt University/Ingram Cancer Center
- Texas Cancer Center
- The Don and Sybil Harrington Cancer Center
- Texas Oncology-Arlington South
- Texas Oncology-Austin Midtown
- Texas Oncology - Central Austin Cancer Center
- Texas Oncology - South Austin Cancer Center
- Texas Oncology Bedford
- Parkland Memorial Hospital
- UT Southwestern/Simmons Cancer Center-Dallas
- Texas Oncology-Flower Mound
- The Klabzuba Cancer Center
- Memorial Hermann Memorial City Medical Center
- M D Anderson Cancer Center
- The Methodist Hospital System
- MD Anderson Regional Care Center-Katy
- Doctor's Hospital of Laredo
- Covenant Medical Center-Lakeside
- University Medical Center
- Texas Tech University Health Sciences Center-Lubbock
- MD Anderson Regional Care Center-Bay Area
- Texas Oncology-Plano West
- Scott and White Healthcare Round Rock
- Texas Oncology - Round Rock Cancer Center
- University of Texas Health Science Center at San Antonio
- Texas Cancer Center-Sherman
- MD Anderson Regional Care Center-Sugar Land
- Texas Oncology Cancer Center Sugar Land
- Scott and White Memorial Hospital
- MD Anderson Regional Care Center-The Woodlands
- Deke Slayton Cancer Center
- Intermountain Medical Center
- Utah Valley Regional Medical Center
- Huntsman Cancer Institute/University of Utah
- South Jordan Health Center
- Norris Cotton Cancer Center-North
- Inova Alexandria Hospital
- University of Virginia Cancer Center
- Inova Fairfax Hospital
- Augusta Health Cancer Center
- Mary Washington Hospital
- Sentara Cancer Institute at Sentara CarePlex Hospital
- Sentara Norfolk General Hospital
- Naval Medical Center - Portsmouth
- Virginia Commonwealth University/Massey Cancer Center
- Oncology and Hematology Associates of Southwest Virginia
- Sentara Virginia Beach General Hospital
- MultiCare Auburn Medical Center
- Overlake Hospital Medical Center
- Harrison Medical Center
- Virginia Mason Federal Way Medical Center
- Tacoma/Valley Radiation Oncology Centers-Gig Harbor
- MultiCare Gig Harbor Medical Park
- Tri-Cities Cancer Center
- Skagit Valley Hospital Regional Cancer Care Center
- MultiCare Good Samaritan Hospital
- Tacoma/Valley Radiation Oncology Centers-Puyallup
- Virginia Mason Medical Center
- Fred Hutchinson Cancer Research Center
- Seattle Cancer Care Alliance
- University of Washington Medical Center
- Cancer Care Northwest - Spokane South
- Spokane Valley Cancer Center-Mayfair
- MultiCare Tacoma General Hospital
- Northwest Medical Specialties PLLC
- Saint Joseph Medical Center
- Tacoma/Valley Radiation Oncology Centers-Saint Joe's
- Compass Oncology Vancouver
- West Virginia University Healthcare
- Langlade Hospital and Cancer Center
- Fox Valley Surgical Associates Limited
- Radiology Associates of Appleton/ThedaCare Regional Medical Center
- ThedaCare Regional Cancer Center
- Sacred Heart Hospital
- Aurora Cancer Care-Grafton
- Saint Vincent Hospital Cancer Center Green Bay
- Saint Vincent Hospital Cancer Center at Saint Mary's
- Aurora BayCare Medical Center
- UW Cancer Center Johnson Creek
- Aurora Cancer Care-Kenosha South
- Gundersen Lutheran Medical Center
- Mayo Clinic Health System-Franciscan Healthcare
- University of Wisconsin Hospital and Clinics
- Marshfield Clinic
- Saint Joseph's Hospital
- Community Memorial Hospital
- Aurora Saint Luke's Medical Center
- Froedtert and the Medical College of Wisconsin
- Aurora Sinai Medical Center
- Marshfield Clinic-Minocqua Center
- Surgical Associates of Neenah SC
- ProHealth Oconomowoc Memorial Hospital
- Vince Lombardi Cancer Clinic - Oshkosh
- Wheaton Franciscan Cancer Care - All Saints
- Marshfield Clinic-Rice Lake Center
- Saint Michael's Hospital
- Marshfield Clinic Stevens Point Center
- Aurora Medical Center in Summit
- Vince Lombardi Cancer Clinic-Two Rivers
- ProHealth Waukesha Memorial Hospital
- UW Cancer Center at ProHealth Care
- Aspirus Regional Cancer Center
- Aurora Cancer Care-Milwaukee West
- Aurora West Allis Medical Center
- The Alyce and Elmore Kraemer Cancer Care Center
- Diagnostic and Treatment Center
- Tom Baker Cancer Centre
- Cross Cancer Institute
- CancerCare Manitoba
- Atlantic Health Sciences Corporation-Saint John Regional Hospital
- University Health Network-Princess Margaret Hospital
- CIUSSSEMTL-Hopital Maisonneuve-Rosemont
- McGill University Department of Oncology
- Jewish General Hospital
- CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)
- Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
- Allan Blair Cancer Centre
- Saskatoon Cancer Centre
- Saint Lukes Hospital
- University College Hospital Galway
- Chaim Sheba Medical Center
- Tohoku University School of Medicine
- Hokkaido University Hospital
- Hyogo Cancer Center
- Iwate Medical University School of Medicine
- Gunma University Hospital
- Niigata University Medical and Dental Hospital
- Shikoku Cancer Center
- Saitama Medical University International Medical Center
- Yonsei University Health System-Severance Hospital
- San Juan City Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
No Intervention
Experimental
Experimental
Group 1A Lumpectomy: no regional nodal XRT with WBI
Group 1B Mastectomy: No regional nodal or chestwall XRT
Group 2A lumpectomy: Regional nodal XRT with WBI
Group 2B Mastectomy: Regional nodal XRT and chestwall XRT
Lumpectomy patients undergo whole breast radiation therapy using IMRT or 3D-CRT once daily 5 days a week for 5 weeks followed by a radiation therapy boost to the lumpectomy cavity once daily 5 days a week for 1-1/2 weeks.
Mastectomy patients do not undergo radiation therapy.
Lumpectomy patients undergo regional nodal radiation therapy with whole breast radiation therapy using IMRT or 3D-CRT once daily 5 days a week for 5 weeks followed by a radiation therapy boost to the lumpectomy cavity once daily 5 days a week for 1-1/2 weeks.
Mastectomy patients undergo regional nodal radiation therapy using IMRT or 3D-CRT once daily 5 days a week for 5 weeks.