Single-Photon Emission Computed Tomography, Computed Tomography Lymphoscintigraphy, and Intensity-Modulated Radiation Therapy in Treating Patients Who Have Undergone Surgery for Stage I or Stage II Breast Cancer

OBJECTIVES:

- To assess the feasibility of integrating Philips Precedence SPECT/CT® images with GE
PET/CT Fusion software to reduce radiation dosimetry delivered to lymph nodes draining
the arm in patients after surgery for stage I or II breast cancer.

- To examine the differences in radiation dosimetry in these patients using 3-D conformal
radiotherapy with vs without the Philips Precedence SPECT/CT®.

- To compare reduction in lymph node radiation dosimetry in these patients using single
photon emission computed tomography (SPECT) and computed tomography (CT) with 3-D
conformal radiotherapy vs intensity-modulated radiotherapy.

OUTLINE: Patients receive filtered technetium Tc 99m sulfur colloid (TcSC) intradermally and
undergo single photon emission computed tomography (SPECT) and computed tomography (CT)
imaging at the time of TcSC and 2 hours after injection. Patients then undergo
intensity-modulated radiotherapy of the whole breast, including the low axilla and lymph
nodes identified by the Phillips Precedence SPECT/CT® at a dose determined by computer
analysis of the imaging information.

Patients complete a lymphedema screening questionnaire at baseline and at 12 and 24 months
after treatment.

DISEASE CHARACTERISTICS:

- Biopsy-proven primary invasive breast cancer, meeting one of the following criteria:

- Stage I or II disease with negative sentinel or axillary node dissections

- Stage II disease with micrometastases (defined as < 2.0 mm focus) in 1-2 lymph
nodes and/or a single positive axillary node ≤ 1 cm with no extracapsular
extension

- Completed all surgical intervention (e.g., lumpectomy, mastectomy)

- Planning adjuvant whole breast irradiation including the low axilla

- No bilateral or recurrent breast cancer

PATIENT CHARACTERISTICS:

- ECOG performance status 0-2

- Not pregnancy or nursing

- Negative pregnancy test

- Able to complete questionnaire(s) alone or with assistance

- No active infection

- No history of invasive cancer within the past 5 years, except basal cell or squamous
cell skin cancers

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- No prior surgery or radiation to the ipsilateral breast or axilla

- No concurrent neoadjuvant chemotherapy or radiotherapy