B: Randomized trial of breast irradiation schedules after lumpectomy for women with lymph node-negative breast cancer

Background: Breast irradiation after lumpectomy is an in-tegral component of breast-conserving therapy that reduces the local recurrence of breast cancer. Because an optimal fractionation schedule (radiation dose given in a specified number of fractions or treatment sessions over a defined time) for breast irradiation has not been uniformly accepted, we examined whether a 22-day fractionation schedule was as effective as the more traditional 35-day schedule in reducing recurrence. Methods: Women with invasive breast cancer who were treated by lumpectomy and had pathologically clear resection margins and negative axillary lymph nodes were randomly assigned to receive whole breast irradiation of 42.5 Gy in 16 fractions over 22 days (short arm) or whole breast irradiation of 50 Gy in 25 fractions over 35 days (long arm). The primary outcome was local recurrence of invasive breast cancer in the treated breast. Secondary outcomes in-cluded cosmetic outcome, assessed with the European Orga-nisation for Research and Treatment of Cancer (EORTC) Cosmetic Rating System. All statistical tests were two-sided