Neoadjuvant or Adjuvant Epirubicin, Cyclophosphamide, and Paclitaxel in Treating Women With Stage I, Stage II, or Stage III Breast Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the breast

  • Stage I, II, or III
  • Inflammatory breast cancer allowed

• Hormone receptor status:

  • Not specified

PATIENT CHARACTERISTICS:

Age

• 18 and over

Sex

• Female

Menopausal status

• Not specified

Performance status

• ECOG 0-1

Life expectancy

• Not specified

Hematopoietic

• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3

Hepatic

• Bilirubin normal
• SGOT/SGPT no greater than 2.5 times upper limit of normal (ULN) AND alkaline phosphatase no greater than ULN OR
• SGOT/SGPT no greater than ULN AND alkaline phosphatase no greater than 4 times ULN

Renal

• Not specified

Cardiovascular

• LVEF at least lower limit of normal by MUGA or echocardiogram
• No unstable angina
• No congestive heart failure
• No arrhythmia requiring medical therapy
• No myocardial infarction within the past year

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No prior allergy/hypersensitivity to any of the study drugs or other drugs formulated with Cremophor EL
• No psychiatric illness that would preclude understanding of the nature of the study or study compliance
• No active unresolved infection
• No peripheral neuropathy greater than grade 1
• No other nonmammary malignancy within the past 5 years except adequately treated nonmelanoma skin cancer or carcinoma in situ of the cervix
• No concurrent medical condition that would preclude study participation in the judgment of the investigator

PRIOR CONCURRENT THERAPY:

Biologic therapy

• More than 12 months since prior immunotherapy for prior breast cancer
• No prior or concurrent biologic therapy or immunotherapy for this breast cancer

Chemotherapy

• More than 12 months since prior chemotherapy for prior breast cancer
• No prior anthracycline (i.e., doxorubicin or epirubicin) and taxane therapy
• No prior or other concurrent chemotherapy for this breast cancer

Endocrine therapy

• No concurrent hormonal therapy for chemoprevention

  • Prior hormonal therapy for chemoprevention allowed
• No concurrent sex hormonal therapy (e.g., birth control pills or ovarian hormonal replacement therapy)

Radiotherapy

• No prior radiotherapy
• No other concurrent radiotherapy for this breast cancer

Surgery

• Not specified

Other

• No concurrent digitalis, beta-blockers, or calcium channel blockers for congestive heart failure