Exemestane or Docetaxel-Cytoxan in Low Recurrence Score Cancers

Inclusion Criteria

• •Signed informed consent.
• •Histologically or cytologically confirmed breast carcinoma.
• •Early stage breast cancer (T1c-3, clinically node-negative-3 \[cN0-3\], CM0).
• •Pre-treatment biopsy with the following characteristics:
• •* Hormone receptor-positive cancer as defined as ER and/or progesterone receptor (PR)-positive by standard immunohistochemistry (IHC)
• •* HER2-negative (HER2 ≤ 2 by IHC; if HER2 2+ by IHC must be fluorescent in situ hybridization \[FISH\] non-amplified)
• •* Recurrence score \< 25 using Oncotype DX 21-gene recurrence score assay
• •Patients must have measurable disease as defined by palpable lesion with both diameters ≥ 1 cm measurable with caliper or a positive mammogram or ultrasound with at least one dimension ≥ 1 cm. Screening mammogram of the contralateral breast must be performed within past 12 months per standard practice guidelines. Clip placement is required for study entry.
• •Baseline measurements of the indicator lesions must be recorded on the Patient Registration Form. To be valid for baseline, the measurements must have been made within 14 days of study enrollment if palpable. If not palpable, a mammogram or MRI must be done within 14 days. If palpable, a diagnostic mammogram of the affected breast or MRI must be done within 2 months prior to study enrollment, defined as date of signed, informed consent. If clinically indicated, staging xrays and scans must be done within 28 days of study entry.
• •Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2.
• •Adequate organ function within 14 days of study entry:
• •* Bone marrow function: absolute neutrophil count (ANC) ≥ 1500/mm³, Hgb \> 8.0 g/dl and platelet count ≥ 100,000/mm³.
• •* Hepatic function: total bilirubin \< upper limit of normal (ULN). Serum glutamic oxaloacetic transaminase (SGOT) (AST) or serum glutamic pyruvic transaminase (SGPT) (ALT) and alkaline phosphatase ≤ 1.5 x ULN).
• •* Renal function: calculated creatinine clearance (CrCl) ≥ 30 mL/min using the Cockcroft Gault equation.
• •Patients must be at least 18 years of age.