This trial will be conducted in women with breast cancer that is large and/or attached to nearby tissues, for whom shrinkage of tumour using neoadjuvant therapy before surgery could mean the operation is easier and a smaller operation than mastectomy may be possible. Women with metastatic breast cancer are excluded. The current standard for women with larger ER positive breast cancer is preoperative chemotherapy alone, followed by surgery, then adjuvant endocrine therapy. Endocrine therapy is regarded as the mainstay of adjuvant treatment for women with receptor positive breast cancer, and neoadjuvant chemotherapy rarely results in complete disappearance of cancer by the time of surgery. The purpose of this trial is to examine whether combining chemotherapy and endocrine therapy is more effective than chemotherapy alone at downstaging receptor positive breast cancer before surgery. All participants will receive active treatment with neoadjuvant chemotherapy, with or without letrozole (and goserelin for pre/peri menopausal women). |
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