accelerated partial breast radiation therapy using high-dose rate brachytherapy in treating patients with early stage breast cancer after surgery

Conditions: Ductal Breast Carcinoma In Situ; Estrogen Receptor Positive; Invasive Breast Carcinoma; Progesterone Receptor Positive; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer

Summary: this phase ii trial studies how well accelerated partial breast irradiation (apbi) using high-dose rate (hdr) brachytherapy works in treating patients with breast cancer that has not spread beyond the breast or the axillary lymph nodes (early-stage) after surgery. radiation therapy uses a type of energy to kill cancer cells and shrink tumors. brachytherapy is a type of internal radiation therapy that provides radiation inside the breast to any remaining tumor cells next to the space where the tumor was removed, and is given over a shorter amount of time than standard radiation therapy. giving accelerated partial breast irradiation (apbi) using high-dose rate (hdr) brachytherapy may reduce the overall time that radiation is delivered to the tumor cells.

primary objectives: i. to determine the toxicity rate with shorter courses of accelerated partial breast irradiation (apbi) delivered with a breast brachytherapy applicator. secondary objectives: i. to determine the 3-year actuarial local control rate with abbreviated accelerated partial breast irradiation (apbi). ii. to assess the rate of excellent or good cosmesis at 2-years after shorter courses of apbi and to identify co-variants associated with and predictive of poor cosmetic outcome in women treated with an overnight treatment course of apbi. outline: within 1-5 days after balloon placement, patients undergo accelerated partial breast irradiation (apbi) using high-dose rate (hdr) brachytherapy over 15-60 minutes for 2-3 days. after completion of study treatment, patients are followed up at 2-8 weeks and then at least annually for 2 years.

Eligibility criteria:
inclusion criteria: * must sign informed consent * surgical treatment of the breast must have been lumpectomy; the margins of the resected specimen must be histologically free of tumor (negative surgical margins per national surgical adjuvant breast and bowel project \[nsabp\] criteria) * on histologic examination, the tumor must be ductal carcinoma in situ (dcis) and/or invasive breast carcinoma * for patients with invasive breast cancer, an axillary staging procedure must be performed (either sentinel node biopsy \[snb\] alone or axillary dissection \[with a minimum of six axillary nodes removed\], and the axillary node\[s\] must be pathologically negative); patients over 70 with estrogen receptor positive (er+) tumors no greater than 2 cm do not require axillary evaluation, but must be clinically node negative on examination and all available imaging (clinical n0) * the t stage must be tis, t1, or t2; if t2, the tumor must be =\< 3.0 cm in maximum diameter * estrogen receptor positive tumor and/or progesterone receptor positive tumor exclusion criteria: * pregnant or breast-feeding * active collagen-vascular disease * paget's disease of the breast * prior history of dcis or invasive breast cancer * prior breast or thoracic radiation therapy (rt) for any condition * multicentric carcinoma (dcis or invasive) * synchronous bilateral invasive or non-invasive breast cancer * surgical margins that cannot be microscopically assessed or that are positive * positive axillary node(s) * t stage of t2 with the tumor \> 3 cm in maximum diameter or a t stage \>= 3 * estrogen receptor negative and progesterone receptor negative tumor * any of the dosimetric treatment criteria as defined have not been met; patients who become ineligible due to inability to meet dosimetric criteria should not receive treatment as defined in this protocol and will come off the study; any subsequent adjuvant radiation will be delivered at the discretion of the treating physician