Paclitaxel With or Without Carboplatin and/or Bevacizumab Followed By Doxorubicin and Cyclophosphamide in Treating Patients With Breast Cancer That Can Be Removed by Surgery

Inclusion Criteria:

• Histologically confirmed invasive breast cancer by core needle or incisional biopsy (excisional biopsy is not allowed)

  • Clinical stage II-III disease

    • No inflammatory breast cancer

  • Resectable disease

    • Intent to undergo surgery after completion of neoadjuvant therapy
• Hormone receptor status poor, defined as estrogen receptor-negative and progesterone receptor-negative tumor OR staining present in ≤ 10% of invasive cancer cells by IHC
• HER2-negative disease, defined as IHC0-1+ OR FISH ratio (HER2 gene copy/chromosome 17) of < 2.0

• Measurable disease, defined as clinically orradiographically measurable target lesion in the breast that is ≥ 1 cm

  • No axillary disease only (i.e., no identifiable tumor in the breast that is ≥ 1 cm onphysical exam or radiographic study)
• Multicentric or bilateral disease allowed provided the target lesion meets the above eligibility criteria
• Concurrent registration on CALGB-150709 required
• Menopausal status not specified
• Zubrod performance status 0-1
• Granulocytes ≥ 1,000/μL
• Platelets ≥ 100,000/μL
• Total bilirubin ≤ 1.5 times upper limit of normal(ULN)
• ALT ≤ 2.5 times ULN
• Creatinine clearance> 30 mL/min
• Urine protein ≤ 1+ by urinalysis OR urine protein:creatinine ratio < 1 OR 24-hour urine protein < 1 g
• PT/INR ≤ 1.5 times ULN (INR ≤ 3 times ULN if patient is on stable, therapeutic doses of warfarin and has no active bleeding or pathologic condition that is associated with a high risk of bleeding)
• LVEF > lower limit of normal by MUGA scan or echocardiogram
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective, non-hormonal contraception during the entire period of study treatment
• No significant history of bleeding (e.g., hemoptysis, upper or lower gastrointestinal bleeding) within the past 6 months
• No serious or non-healing wound, skin ulcer, or bone fracture
• No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 6 months
• No baseline neuropathy ≥ grade 2
• No congestive heart failure
• No myocardial infarction, unstable angina pectoris, arterial thrombotic event, stroke, or transient ischemia attack within the past 12 months
• No uncontrolled hypertension (systolic blood pressure [BP] > 160 mm Hg or diastolic BP > 90 mm Hg), uncontrolled or symptomatic arrhythmia, or peripheral vascular disease ≥ grade 2

• More than 28 days since prior and no concurrent major surgical procedure; the following are NOT considered to be major surgical procedures:

  • Obtaining the required research needle biopsies
  • Placement of a radiopaque clip to localize a tumor or tumors for subsequent surgical resection
  • Placement of a port for central venous access
  • Fine needle aspiration of a prominent or suspicious axillary lymph node
  • Needle biopsy of a clinically or radiographically detected lesion to rule out metastatic disease
  • Pretreatment sentinel lymph node sampling
• No prior chemotherapy, hormonal therapy, or radiotherapy with therapeutic intent for this cancer
• No other concurrent chemotherapy
• No concurrent hormonal therapy, except steroids for adrenal failure or hormones for non-disease-related conditions (e.g., insulin for diabetes, dexamethasone as pre-treatment for paclitaxel, or dexamethasone as an antiemetic)