The purpose of this study is to determine the efficacy of neoadjuvant treatment with pegylated liposomal doxorubicin (Caelyx) and cyclophosphamide +/- trastuzumab followed by docetaxel in patients with locally advanced, inflammatory breast cancer or with a primary tumor > 5 cm.

Patients with locally advanced or inflammatory breast cancer have a very bad prognosis. Several studies have shown that patients who receive a pathological complete response have the best prognosis. Neoadjuvant chemotherapy including anthracyclines and taxanes has become established as a standard option in the multidisciplinary management of this group of patients. In HER2 positive patients, chemotherapy in combination with trastuzumab is therapeutically attractive. Recent studies have also demonstrated that evaluation with PET-CT scan can be used to stratify treatment and monitor early response to neoadjuvant therapy.

Inclusion Criteria:

• pathologically proven breast cancer
• inflammatory, locally advanced breast cancer or a tumor > 5 cm
• ECOG performance status < 2
• LVEF > 50% measured by MUGA (HER2 positive patients)
• adequate bone marrow, liver and renal function
• written informed consent must be obtained

Exclusion Criteria:

• another malignancy within 5 years prior to study entry
• concurrent treatment with an investigational agent
• other disease or condition that contraindicates participation in the study
• pregnant or lactating females