Adjuvant Chemotherapy in Treating Women Who Have Undergone Resection for Relapsed Breast Cancer; Chemotherapy as Adjuvant for LOcally Recurrent Breast Cancer

DISEASE CHARACTERISTICS:

   - Histologically confirmed invasive breast cancer

      - First local and/or regional (i.e., ipsilateral axillary or internal mammary lymph
      node region) recurrence after primary treatment with mastectomy or
      lumpectomy/quadrantectomy with clear surgical margins

         - Local failure is defined as a tumor recurrence in any soft tissue of the
         ipsilateral conserved breast or the chest wall, mastectomy scar, and/or skin

         - Regional failure is defined as a tumor recurrence in the ipsilateral
         axillary lymph nodes, extranodal soft tissue of the ipsilateral axilla,
         and/or ipsilateral internal mammary. Regional failure does not include
         supraclavicular lymph nodes or tumor in the opposite breast

      - No other prior recurrence in any site, including local

   - Surgical resection of the recurrence meeting 1 of the following criteria:

      - Uninvolved ("clear") margins and planned radiotherapy with at least 40 Gy for
      patients who had no prior adjuvant radiotherapy

      - Mastectomy of the recurrence with uninvolved ("clear") margins after
      lumpectomy/quadrantectomy alone for the primary

   - Adjuvant trastuzumab (Herceptin®) therapy or other HER-2 directed therapies are
   allowed for patients with HER-2 positive tumors and must be declared prior to
   randomization

   - No evidence of distant metastasis, including ipsilateral supraclavicular lymph nodes,
   by x-ray or CT scan of the chest, ultrasound or CT scan of the abdomen and pelvis, or
   bone scintigraphy only if alkaline phosphatase is > 2 times normal or if medically
   indicated (e.g., bone pain)

   - No macroscopically incomplete surgery

   - No bilateral malignancy except carcinoma in situ

   - No suspicious mass in the opposite breast unless that mass has been proven by biopsy
   to be benign

   - No skeletal pain of unknown cause

      - No hot spots on bone scan for which metastases cannot be ruled out by x-ray, MRI,
      and/or CT scan

   - Hormone receptor status:

      - Determined in the recurrent tumor by immunohistochemistry and/or ligand-binding
      assay

      - Estrogen receptor positive or negative

      - Progesterone receptor positive or negative

PATIENT CHARACTERISTICS:

Age

   - Minimum 18 years

Sex

   - Female

Menopausal status

   - Not specified

Performance status

   - Not specified

Life expectancy

   - Not specified

Hematopoietic

   - Not specified

Hepatic

   - No elevated alkaline phosphatase

Renal

   - Not specified

Other

   - Fertile patients must use effective non-hormonal contraception

   - Medically suitable for chemotherapy of 3-6 months duration

   - No other primary malignant tumors except adequately treated carcinoma in situ of the
   cervix or nonmelanoma skin cancer

   - No non-malignant systemic disease that would preclude study treatment or prolong
   follow-up

   - No psychiatric or addictive disorder that would preclude giving informed consent

   - No history of noncompliance to medical regimens or potential for being unreliable

PRIOR CONCURRENT THERAPY:

Biologic therapy

   - Not specified

Chemotherapy

   - See Disease Characteristics

Endocrine therapy

   - Not specified

Radiotherapy

   - See Disease Characteristics

Surgery

   - See Disease Characteristics