Statement: T4 N3 M0 adenocarcinoma of the breast are eligible for the primary trial.
Primary_evidence: DISEASE CHARACTERISTICS:   Histologically proven invasive carcinoma of the breast   No evidence of T4, N2-3, or M1 disease prior to surgery   Node positive or high-risk node negative   Prior breast-conserving therapy (BCT) (e.g., lumpectomy, partial mastectomy, or segmental mastectomy) and axillary node dissection or sentinel node biopsy required and must be a candidate for breast radiotherapy after BCT   Normally patients should have microscopically clear resection margins and those with positive margins should undergo reexcision   Patients with microscopically focally positive margins (defined as no greater than 3 times high power fields) are candidates for breast radiotherapy plus a boost to the lumpectomy site   Patients with prior sentinel node dissection eligible if node negative, but still meet high-risk criteria   If node positive, then a level I and II axillary dissection must be performed   No evidence of residual disease in axilla after dissection   Must be treated with currently accepted adjuvant systemic chemotherapy and/or hormonal therapy   High risk of regional and systemic recurrence due to one of the following:   Pathologically positive axillary lymph nodes   Pathologically negative axillary lymph nodes with one of the following:   Primary tumor greater than 5 cm   Primary tumor greater than 2 cm and less than 10 axillary lymph nodes excised and one of the following:   Estrogen receptor negative   Skarf-Bloom-Richardson grade 3   Lymphovascular invasion   Hormone receptor status:   Estrogen and progesterone receptor status known   PATIENT CHARACTERISTICS:   Age:   16 and over   Sex:   Female   Menopausal status:   Premenopausal or postmenopausal Performance status:   ECOG 0-2   Life expectancy:   At least 5 years   Hematopoietic:   Not specified   Hepatic:   SGOT and/or SGPT no greater than 3 times upper limit of normal (ULN)*   Alkaline phosphatase no greater than 3 times ULN* NOTE: * Patients with laboratory values greater than 3 times ULN may still be eligible if no metastatic disease by imaging examinations   Renal:   No serious nonmalignant renal disease   Cardiovascular:   No serious nonmalignant cardiovascular disease   Pulmonary:   No serious nonmalignant pulmonary disease   Other:   Not pregnant or nursing   Fertile patients must use effective contraception   No other serious nonmalignant disease (e.g., systemic lupus erythematosus or scleroderma) that would preclude definitive surgery or radiotherapy   No other malignancy except:   Nonmelanomatous skin cancer   Carcinoma in situ of the cervix or endometrium   Contralateral noninvasive breast cancer (unless prior radiotherapy to the contralateral breast)   Invasive carcinoma of the cervix, endometrium, colon, thyroid, or melanoma that was curatively treated at least 5 years prior to study participation   No psychiatric or addictive disorder that would preclude informed consent or study compliance   PRIOR CONCURRENT THERAPY:   Biologic therapy:   Not specified   Chemotherapy:   See Disease Characteristics   Concurrent standard adjuvant chemotherapy allowed   Endocrine therapy:   See Disease Characteristics   Concurrent standard adjuvant hormonal therapy allowed   Radiotherapy:   See Disease Characteristics   Surgery:   See Disease Characteristics