Prognostic Study of Sentinel Lymph Node and Bone Marrow Metastases in Women With Stage I or Stage IIA Breast Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed stage I or IIA (T1 or T2 N0 M0) invasive breast carcinoma diagnosed within 60 days of sentinel lymph node dissection

  • Cytologic diagnosis suggestive of carcinoma from a fine needle aspiration of a palpable or nonpalpable breast lesion allowed if clinically suspicious for invasive breast carcinoma
  • Tumor must be amenable to segmental mastectomy (lumpectomy)
  • No clinically and radiologically identified multicentric disease that is not amenable to a single lumpectomy
  • No concurrent bilateral invasive breast malignancies
• No tumors in the medial hemisphere of the breast that show complete absence of drainage to the axilla by lymphoscintigram

• Hormone receptor status:

  • Not specified

PATIENT CHARACTERISTICS:

Age:

• Over 18

Sex:

• Female

Menopausal status:

• Not specified

Performance status:

• ECOG 0-2 OR
• Zubrod 0-2

Life expectancy:

• Not specified

Hematopoietic:

• Not specified

Hepatic:

• Not specified

Renal:

• No renal disease that would increase surgical risk

Cardiovascular:

• No cardiovascular disease that would increase surgical risk

Other:

• No other malignancy within the past 5 years except curatively treated basal cell or squamous cell skin cancer, surgically treated carcinoma in situ of the cervix, or curatively treated lobular carcinoma in situ of the ipsilateral or contralateral breast with a low risk of recurrence
• No other nonmalignant systemic disease that would increase surgical risk
• No active connective tissue disorders
• Able to undergo and have access to radiotherapy
• Physically able to undergo bilateral anterior iliac crest bone marrow aspiration
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior chemotherapy for invasive breast cancer

Endocrine therapy:

• No prior estrogen-receptor antagonists (e.g., tamoxifen) or selective estrogen-receptor modulators (e.g., raloxifene) for invasive breast cancer

Radiotherapy:

• Not specified

Surgery:

• See Disease Characteristics
• No prior ipsilateral axillary surgery (e.g., excisional biopsy of lymph nodes or treatment of hidradenitis)
• No pre-pectoral breast implant
• Subpectoral implant allowed