Statement: the secondary trial and the primary trial accept patients in the same age range.
Primary_evidence: Inclusion Criteria:   Female breast cancer patients over the age of 18 will be recruited for this study. Patients enrolled in the study will meet standard criteria for whole breast XRT. Exclusion Criteria:   Subjects will be excluded for a number of medical conditions that are contraindications to XRT and/or might confound the relationship among fatigue, and inflammation, including pregnancy, major psychiatric disorders, autoimmune or inflammatory disorders, chronic infectious diseases (e.g. HIV, hepatitis B or C), neurologic disorders and uncontrolled cardiovascular, metabolic, pulmonary or renal disease (as determined by medical history, physical examination and laboratory testing). Subjects with a history of a major psychiatric disorder including Schizophrenia or Bipolar Disorder or a diagnosis of Substance Abuse or Dependence within the past 1 year (as determined by standardized psychiatric interview) will be excluded. Subjects taking drugs known to affect the immune system (e.g. glucocorticoids, methotrexate) will also be excluded. Subjects using supplements or other natural products with one week of starting medications, excluding vitamins and calcium supplementation or at the discretion of the attending physician, will be excluded. Patients who have evidence of infection as determined by history, physical exam or laboratory testing (complete blood count and urinalysis) at baseline will be excluded. In addition, patients who develop evidence of infection (as determined by history, physical exam or laboratory testing) during the study will be discontinued from the study.
Secondary_evidence: DISEASE CHARACTERISTICS:   Histologically confirmed primary adenocarcinoma of the breast   Stage I-III disease   No evidence of metastatic disease   Must have undergone lumpectomy or total mastectomy for primary disease within the past 12 weeks, or have completed chemotherapy within the past 8 weeks   Axillary evaluation per institutional standards   Currently receiving or planning to receive standard adjuvant systemic therapy comprising chemotherapy, hormonal therapy, or combined chemotherapy/hormonal therapy for breast cancer   Patients who are at low risk for disease recurrence and for whom adjuvant systemic therapy will not be prescribed are not eligible   Patients who receive biologic agents only or local radiotherapy only (without chemotherapy and/or hormone therapy) are not eligible   Additional therapies are allowed including radiotherapy and biologic agents (e.g., trastuzumab [Herceptin^®], bevacizumab, or hematopoietic growth factors)   Neoadjuvant therapy or hormonal therapy alone is allowed provided study entry occurs  12 weeks after completion of surgery   Patients with skeletal pain are eligible provided bone scan and/or roentgenological exam are negative for metastatic disease   Suspicious findings must be confirmed as benign by x-ray, MRI, or biopsy   Hormone receptor status:   Not specified   PATIENT CHARACTERISTICS:   Age   18 and over   Sex   Female   Menopausal status   Not specified   Performance status   Zubrod 0-2   Life expectancy   Not specified   Hematopoietic   Not specified   Hepatic   Not specified   Renal   Creatinine  2 times upper limit of normal   Creatinine clearance  30 mL/min   No renal failure   Other   Not pregnant or nursing   Negative pregnancy test   Fertile patients must use effective contraception   No history of esophageal stricture or motility disorders   Gastroesophageal reflux disorder allowed   No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I or II cancer in complete remission   PRIOR CONCURRENT THERAPY:   Biologic therapy   Prior or concurrent hematopoietic growth factors allowed   HER-2-targeted therapies allowed   Antiangiogenics allowed   Chemotherapy   See Disease Characteristics   Endocrine therapy   See Disease Characteristics   Radiotherapy   Concurrent radiotherapy to the breast, chest wall, or lymph node group allowed at the discretion of the treating physician   Surgery   See Disease Characteristics   Other   Prior neoadjuvant therapy allowed   Prior bisphosphonates for bone density allowed   No other concurrent bisphosphonates as adjuvant therapy or for treatment of osteoporosis   No concurrent enrollment in clinical trials with bone density as an endpoint   Concurrent enrollment on any other locoregional or systemic therapy breast cancer study (including cooperative group studies) allowed