breast-conserving surgery followed by radiation therapy with mri-detected stage i or stage ii breast cancer

Conditions: Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage I Breast Cancer; Stage II Breast Cancer; Tubular Ductal Breast Carcinoma

Summary: rationale: breast-conserving surgery is a less invasive type of surgery for breast cancer and may have fewer side effects and improve recovery. radiation therapy uses high-energy x-rays to kill tumor cells. giving radiation therapy after surgery may kill any tumor cells that remain after surgery. purpose: this phase ii clinical trial is studying how well breast-conserving surgery followed by radiation therapy works in treating patients with stage i or stage ii breast cancer.

primary objectives: i. to determine ipsilateral breast tumor recurrence rates as well as tumor bed recurrence rates. patients will be followed for a period of five years following completion of radiation to determine these rates. ii. to determine the cosmetic outcome resulting from breast conserving surgery and breast radiation. secondary objectives: i. to determine if there are patient factors which limit a patient's suitability to receive breast conserving therapy in the setting of multi-centric disease. ii. to determine patient satisfaction of breast conserving therapy as it pertains to their overall treatment experience as measured by a questionnaire. iii. to evaluate wound healing and overall complication rate after radiation as a component of breast conserving therapy. outline: patients undergo breast-conserving surgery consisting of partial mastectomies followed by external beam breast radiation therapy 5 days a week for 5 weeks in the absence of disease progression or unacceptable toxicity. after completion of study treatment, patients are followed at 1 month, then every 3 months for 1 year, every 6 months for 1 year, and then annually for 5 years.

Eligibility criteria:
inclusion * patients with multicentric carcinoma (tumors in different quadrants of the breast or tumors separated by at least 4 cm) * all radiographically suspicious lesions must be biopsied and have histologically confirmed ductal carcinoma in-situ, invasive ductal, invasive lobular, medullary, papillary, colloid (mucinous), or tubular histologies * a maximum of two radiographically detected malignant lesions * clinical stage i-ii breast carcinoma, with lesion size =\< 5 cm for the dominant mass and the second lesion detected only on mri, treated with lumpectomies; the mri detected lesion must be pathologically =\< 1 cm * axillary lymph node evaluation, either sentinel lymph node biopsy or axillary dissection as deemed appropriate by the treating surgeon for all patients with invasive cancer; no axillary lymph node sampling is needed for patients with dcis * negative resection margins with at least a 2 mm margin from invasive and in-situ cancer or a negative re-excision * a posterior margin =\< 2 mm from dcis is permissible provided fascia was taken * patients are eligible regardless of estrogen receptor, progesterone receptor, or her-2/neu amplification * hormonal therapy is allowed; if adjuvant chemotherapy is planned, the chemotherapy should be delivered first and radiation must begin no earlier than three weeks and no later than eight weeks following completion of chemotherapy * signed study-specific informed consent prior to study entry exclusion * extensive intraductal component by the harvard definition (i.e., more than 25% of the invasive tumor is dcis and dcis present in adjacent breast tissue) * palpable or radiographically suspicious contralateral axillary, ipsilateral or contralateral supraclavicular, infraclavicular, or internal mammary lymph nodes unless these are histologically confirmed negative * patients receiving neoadjuvant chemotherapy * patients with distant metastatic disease detected by radiographic imaging; specific studies for systemic imaging should be obtained as directed by localized symptoms or per available nccn guidelines * patients with known brca 1/brca 2 mutations or those with predicted risk of carrying the mutation by brcapro (44) risk assessment \>= 50% * diffuse calcifications throughout the breast * patients with skin involvement or inflammatory breast cancer * patients with paget's disease of the nipple * patients nonepithelial breast malignancies such as lymphoma or sarcoma * patients with collagen vascular disorders, specifically systemic lupus erythematosis, scleroderma, or dermatomyositis * patients with psychiatric, neurologic, or addictive disorders that would preclude obtaining informed consent * other malignancy, except non-melanomatous skin cancer, \< 5 years prior to participation in this study * patients who are pregnant or lactating, due to potential fetal exposure to radiation and unknown effects of radiation on lactating females