A Prospective, Multicenter, Open-label 12 Week Neoadjuvant Phase II Trial Optimizing Taxane Therapy in Elderly Patients With Low Response

General Inclusion Criteria for ADAPT: * Female patients, age at diagnosis 18 years and above (consider patients at 70 years and above for ADAPT Elderly) * Candidate for chemotherapy on the basis of conventional criteria * Histologically confirmed unilateral primary invasive carcinoma of the breast * Clinical T1 - T4a-c * All clinical N (cN) * No clinical evidence for distant metastasis (M0) * Known HR status and HER2 status (local pathology) * Tumor block available for central pathology review * Performance Status ECOG \<= 1 or KI \>= 80% * Written informed consent prior to beginning specific protocol procedures, including expected cooperation of the patients for the treatment and follow-up, must be obtained and documented according to the local regulatory requirements * The patient must be accessible for treatment and follow-up * Patients must qualify for neoadjuvant treatment * LVEF \> 50%; LVEF within normal limits of each institution measured by echocardiography and normal ECG (within 42 days prior to chemotherapy) * Laboratory requirements : * Leucocytes ≥ 3.5 x 109/L * Platelets ≥ 100 x 109/L * Hemoglobin ≥ 10 g/dL * Total bilirubin ≤ 1 x ULN * ASAT (SGOT) and ALAT (SGPT) ≤ 2.5 x UNL * Creatinine ≤ 175 µmol/L (2 mg/dl) Additional inclusion criteria ADAPT Elderly: * ≥ 70 years old * Charlson scale ≤ 2 * HR+/HER2- disease: if RS and sequential testing are available N0-1/RS 12-25/poor response or N0-1/RS ≥26 * All G3 with Ki-67 ≥40% in tumors \>1cm * All N2 * All TN * All subtypes General Exclusion Criteria for ADAPT: * Known hypersensitivity reaction to the compounds or incorporated substances * Prior malignancy with a disease-free survival of \< 10 years, except curatively treated basalioma of the skin, pTis of the cervix uteri * Non-operable breast cancer including inflammatory breast cancer * Previous or concurrent treatment with cytotoxic agents for any reason after consultation with the sponsor * Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational not marketed drug within 30 days prior to study entry (concurrent participation in non-interventional post authorization safety studies not influencing the primary study endpoints is allowed, e.g. WSG PROTROCA for evaluation of primary/secondary G-CSF prophylaxis) * Male breast cancer * Sequential breast cancer * Reasons indicating risk of poor compliance * Patient not able to consent Additional Exclusion Criteria ADAPT Elderly: * Known polyneuropathy ≥ grade 2 * Severe and relevant co-morbidity that would interact with the application of cytotoxic agents or the participation in the study * Inadequate organ function (e.g. hepatic impairment, pulmonary disease, etc.) * Uncompensated cardiac function (current unstable ventricular arrhythmia requiring treatment, history of symptomatic CHF NYHA classes II-IV), history of myocardial infarction or unstable angina pectoris within 12 months of enrollment, history of severe hypertension, CAD - coronary artery disease) * Severe dyspnea * Pneumonitis * Abnormal blood values: * Thrombocytopenia \> CTCAE grade 1 * Increases in ALT/AST \> CTCAE grade 1 * Hypokalaemia \> CTCAE grade 1 * Neutropenia \> CTCAE grade 1 * Anaemia \> CTCAE grade 1