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 years (yrs) and with estrogen receptor (ER)+ positive tumor =< 2.0 cm may enroll without surgical lymph node evaluation; 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
• Patient >= 18 years of age
• 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