Hypofractionated Radiation Therapy in Treating Patients With Stage 0-IIB Breast Cancer

Inclusion Criteria:

Histologically confirmed invasive carcinoma and/or ductal carcinoma in situ (DCIS) of the breast
Final pathologic Tis, T1-T3, all must be N0 and M0 status.
Negative inked histologic margins from lumpectomy, with the exception of a focus of positive margin at the pectoralis fascia
Radiation oncologist does not plan to treat regional lymph nodes beyond standard whole breast tangent fields
Lumpectomy with negative lymph node on surgical evaluation (Isolated tumor cells in lymph nodes will be permitted). Patients with invasive carcinoma ≥ 70 yrs and with ER+ positive tumor ≤ 2.0cm may enroll without surgical lymph node evaluation, per section 5.1. Patients with Ductal Carcinoma In Situ (DCIS) of the breast only may enroll without surgical lymph node evaluation.

Negative serum or urine beta-human chorionic gonadotropin (HCG) in women of child-bearing potential =< 7 days prior to registration

A female of childbearing potential is a sexually mature female who has not undergone a hysterectomy or bilateral oophorectomy and has not been naturally postmenopausal for at least 12 consecutive months
Women of child-bearing potential must agree to utilize a form of birth control or agree to undergo sexual abstinence during radiation therapy
Eastern Cooperative Oncology Group (ECOG) (Zubrod) performance status 0-1
Able to provide informed consent and willing to sign an approved consent form that conforms to federal and institutional guidelines

Exclusion Criteria:

Prior radiation therapy to the chest, neck or axilla
Prior history of ipsilateral breast cancer (invasive disease or DCIS); lobular carcinoma in situ (LCIS) and benign breast disease is allowed
History of prior or concurrent contralateral invasive breast cancer; benign breast disease, LCIS or DCIS of contralateral breast is allowed
Active collagen vascular diseases, such as: systemic lupus erythematous, scleroderma, or dermatomyositis
Significant post lumpectomy complications requiring an unplanned re-operation or admission for intravenous (IV) antibiotics; re-operation for margins evaluation or nodal evaluation is acceptable
Co-existing medical conditions with life expectancy < 5 years
Other malignancy within 5 years of registration with the exception of basal cell or squamous cell carcinoma of the skin treated with local resection only or carcinoma in situ of the cervix
Neoadjuvant chemotherapy or adjuvant chemotherapy delivered before radiation
Neuroendocrine carcinoma or sarcoma histology
Concurrent radiation sensitizing medications concurrent with radiation, per treatment physician