Trial of Chemotherapy and Avastin as Treatment for Women With Breast Cancer at High Risk for Relapse

Inclusion Criteria: General health * Women Age \>18. * ECOG Performance status 0-1 * Life expectancy must be 3 months. Clinical stage * Histologically or cytologically adenocarcinoma of breast * Pre-operative stage II-III per AJCC 6th edition, based on baseline evaluation by clinical examination, breast imaging, and/or preoperative work-up. * Evidence of residual invasive breast cancer or node positive disease following neoadjuvant chemotherapy. Prior Therapy * Patients must have received primary (neoadjuvant) chemotherapy for local or locoregional breast cancer containing an anthracycline and a taxane. * Patients must have completed definitive resection of primary tumor with adequate excision of gross disease. * Patients must have residual invasive carcinoma in the breast and/or residual carcinoma in one or more regional nodes following preoperative chemotherapy. Adequate hematologic and metabolic parameters within four weeks of study entry defined as: * Absolute neutrophil count ≥1,500/mm3 Platelets ≥ 150,000/mm3 * Total bilirubin ≤ 2.0 mg/dL * Serum creatinine ≤ 2x upper limit of normal * Serum calcium ≤1.5x upper normal limit Concurrent treatments * Current use of anti-coagulants is allowed as long as patients have been on a stable dose for more than 2 weeks with stable INR. * Chronic therapy with full dose aspirin up to 325 mg/day or standard non-steroidal anti-inflammatory agents is allowed. Informed consent * Provision of signed informed consent. Exclusion Criteria: Prior therapy * No prior gemcitabine, continuous infusion 5-FU, or oral fluoropyrimidine (capecitabine, UFT, S-1, 5-FU/eniluracil, etc.) * No known hypersensitivity to capecitabine or prior unanticipated severe reaction to (capecitabine, UFT, S-1, 5-FU/eniluracil, etc.) therapy or known hypersensitivity to 5-fluorouracil. * No concurrent or prior endocrine therapy as adjuvant treatment. * No prior breast radiation * Current, recent (within 4 weeks of the first infusion of this study), or planned participation in another experimental drug study * Stage IV breast cancer * Patients must not have evidence of metastatic disease at enrollment. Women of child-bearing potential. * Nonpregnant and nonlactating. * Women of child-bearing potential must have a negative serum pregnancy test and must agree to an effective means of contraception during the entire study period. Concurrent medical conditions: * No other active cancers, except non-melanoma skin cancers. * No serious infection or other serious underlying medical condition that would otherwise impair their ability to receive protocol treatment. * Patients with clinically significant medical or psychiatric problems which may interfere with treatment on study. Avastin-specific exclusions: * Inadequately controlled hypertension (defined as systolic blood pressure 150 and/or diastolic blood pressure \> 100 mmHg on antihypertensive medications) * Any prior history of hypertensive crisis or hypertensive encephalopathy * New York Heart Association (NYHA) Grade II or greater congestive heart failure * Known CNS disease * Significant vascular disease (e.g., aortic aneurysm, aortic dissection) * Symptomatic peripheral vascular disease * Evidence of bleeding diathesis or coagulopathy * Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study enrollment or anticipation of need for major surgical procedure during the course of the study * Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment * History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment * Serious, non-healing wound, ulcer, or bone fracture * Proteinuria at screening as demonstrated by urine dipstick for proteinuria ≥ 2+ (patients discovered to have ≥2+ proteinuria on dipstick urinalysis at baseline should undergo a 24 hour * urine collection and must demonstrate ≤ 1g of protein in 24 hours to be eligible). * Known hypersensitivity to any component of bevacizumab any history of stroke or transient ischemic attack at any time * History of myocardial infarction or unstable angina within 12 months of study enrollment Inability to comply with study and/or follow-up procedures