Whole Breast Irradiation With Intensity Modulated Radiotherapy and Simultaneously Integrated Boost for Early Stage Breast Cancer Patients
Whole Breast Irradiation With Intensity Modulated Radiotherapy and Simultaneously Integrated Boost for Early Stage Breast Cancer Patients
This is a phase II study. In patients with node-negative invasive breast cancer or carcinoma
 in situ treated by breast conserving surgery, postoperative whole breast irradiation with
 inversely intensity modulated radiotherapy and a simultaneous integrated boost is technically
 feasible. The aim of this study is to evaluate the radiation toxicity, cosmetic outcome and
 local control rate in a single center
Inclusion Criteria:

 -  Eastern Cooperative Oncology Group performance score﹤2

 -  All patients aged >18 years and < 70 years after breast conserving surgery.

 -  On histological examination, the tumor must be DCIS or invasive adenocarcinoma of the
 breast.

 -  Negative nodal status determined by sentinel node biopsy, or axillary dissection.
 Axillary staging is not required for patients with DCIS

 -  No evidence of distant metastasis

 -  Gross disease may be unifocal or multifocal with pathologic (invasive and/or DCIS)
 tumor size excised with negative margins（>2mm）

 -  Surgical treatment of the breast must have been lumpectomy. Re-excision of surgical
 margins is permitted.

 -  The patient must consent to be in the study and must have signed an approved consent
 form.

 Exclusion Criteria:

 -  Eastern Cooperative Oncology Group performance score≧2

 -  Presence of extensive intraductal component (ductal carcinoma in situ occupying > 25%
 of the primary invasive tumour and present adjacent to the primary tumour).Suspicious
 microcalcifications, densities, or palpable abnormalities (in the ipsilateral or
 contralateral breast) unless biopsied and found to be benign.

 -  Proven multicentric carcinoma (invasive cancer or DCIS) in more than one quadrant of
 separated.

 -  Metastatic disease (M1)

 -  Pregnancy or lactating

 -  Surgical margins that cannot be microscopically assessed or are positive at pathologic
 evaluation.

 -  Psychiatric or addictive disorders that preclude obtaining informed consent or
 adherence to protocol.

 -  Collagen vascular disease, specifically dermatomyositis with a CPK level above normal
 or with an active skin rash, systemic lupus erythematosis, or scleroderma.

 -  Prior breast or thoracic RT for any condition.

 -  Previous or concomitant malignancies except non-melanoma skin cancer, carcinoma in
 situ of the cervix, and invasive carcinoma of the colon, thyroid, cervix, or
 endometrium treated five years prior to study entry.

 -  Synchronous chemotherapy or target therapy is not permitted.

 -  Refusal of the patients to be included in the study