The primary aim of this study is to determine whether four cycles of preoperative or postoperative Taxotere given after four cycles of preoperative Adriamycin; and cyclophosphamide will more effectively prolong disease-free survival and survival than do four cycles of preoperative AC alone. The study will also evaluate the effect of the administration of preoperative Taxotere after preoperative AC with respect to clinical and pathologic loco-regional tumor response and breast conservation. Women with palpable, operable carcinoma of the breast diagnosed by fine-needle aspiration cytology or by core needle biopsy will be stratified by age, clinical tumor size, and clinical nodal status, then randomized to one of three groups. In all three groups, tumor measurements will be obtained after each cycle of preoperative chemotherapy. Assessment of response will be performed after completion of all preoperative chemotherapy and before surgery. For patients in group II, an additional assessment of response will be performed after completion of AC chemotherapy. Patients in groups I and II who undergo lumpectomy will receive postoperative radiotherapy after their recovery from surgery. Patients in group III who undergo lumpectomy will receive postoperative radiotherapy after their recovery from the fourth cycle of postoperative Taxotere.
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