Genomically Guided Radiation Therapy in the Management of Triple Negative Breast Cancer

Inclusion Criteria:

• Participants should have undergone breast conservation therapy with a lumpectomy andaxillary evaluation to consist of a sentinel node biopsy or axillary dissection

• Confirmation of Triple Negative (TN) breast cancer by tissue biopsy

• Adequate tissue to calculate RSI

• To fulfill the requirement of HER2- disease, a breast cancer must not demonstrate,at initial diagnosis or upon subsequent biopsy, overexpression of HER2 by either IHCor in-situ hybridization as defined by the ASCO / CAP Guidelines

• To fulfill the requirement of hormone receptor (HR)- disease, a breast cancer mustexpress (<10%), by immunohistochemistry (IHC), the hormone receptors (estrogenreceptor [ER] and progesterone receptor [PR]) as defined in the American Society ofClinical Oncology (ASCO) / College of American Pathologists (CAP) Guidelines

• Life expectancy >16 weeks

• KPS ≥ 70

• Age ≥ 18 years

• Participants with surgery within 14 days should have recovered from all effects ofthe surgery and be cleared by their surgeon

• There is no limit on prior systemic therapies

• Women of childbearing potential and sexually active males must commit to the use ofeffective contraception while on study

• Ability to sign an informed consent form, which can be signed by a family member orhealth care proxy. Informed consent must be given before study enrollment

Exclusion Criteria:

• Major surgery or significant traumatic injury that has not been recovered from 14days before study initiation

• Women who are pregnant or breastfeeding

• Positive surgical margins

• History of allergy or hypersensitivity to any of the study drugs or study drugcomponents

• Metastatic breast cancer