Are there any special radiotherapy considerations for women who have double lumpectomy?

Z11102 looked at multiple ipsilateral breast cancers and lumpectomies. For these cases, I would be fine with hypofractionated WBI. Boost would be based on features of each cancer so if it was otherwise low risk for both, I would omit boost vs. if both were higher risk (< 50, ER-), I would boost both...

If treating with tangent beams, then make sure there is a 5-10 mm gap between two medial fields with no change in dose or fraction.

If suitable for APBI on both sides, that is also an option with IMRT/IGRT.