Alternative Non-cross-resistant Adjuvant Chemotherapy for Operable Breast Cancer Non-response to Primary Chemotherapy

Inclusion Criteria: * Female patients, age ≦65 years * Biopsy proven lymph node positive, estrogen receptor- positive primary breast cancer * Must have completed a 4-cycle neo-adjuvant chemotherapy with a standard regimen(containing anthracycline or paclitaxel) * Must have undergone surgery to remove the primary tumor by either a mastectomy or enlarged local excision * Postoperative residual positive lymph nodes or G1/G2/G3 of Miller \& Payne Grading System * Adequate recovery from recent surgery * No history of other malignancies * No currently uncontrolled diseased or active infection * Not pregnant or breast feeding, and on appropriate birth control if of child-bearing potential * Adequate cardiovascular function reserve with a myocardial infarction within the past six month * Adequate hematologic function with: 1. Absolute neutrophil count (ANC) ≥1500/mm3 2. Platelets ≥100,000/ mm3 3. Hemoglobin ≥10 g/dL * Adequate hepatic and renal function with: 1. Serum bilirubin ≤1.5×UNL 2. Alkaline phosphatase and alanine aminotransferase (ALT) ≤2.5 x ULN. (≤5 x ULN is acceptable in the setting of hepatic metastasis) 3. BUN between 1.7 and 8.3 mmol/L 4. Cr between 40 and 110 umol/L * Knowledge of the investigational nature of the study and Ability to give informed consent * Ability and willingness to comply with study procedures. Exclusion Criteria: * Known or suspected distant metastases * Concurrent malignancy or history of other malignancy * Uncontrolled diseases(e.g., heart failure, myocardial infarction within 6 months, arrhythmia, unstable diabetes, hypercalcemia) or active infection * Geographical, social, or psychological problems that would compromise study compliance * Known or suspected hypersensitivity to anthracycline or paclitaxel