Neoadjuvant Dose-Dense For Early Her2Neu Positive Breast Cancer

Inclusion Criteria: The patient must have signed and dated an IRB-approved consent form that conforms to federal and institutional guidelines. * Female * 18 years or older * ECOG performance status of 0 or 1 * Eligible tumors must meet one of the following criteria: * Operable (T1c, T2-3, N0-1, M0) * Locally advanced (T2-3, N2-3, M0 or T4a-c, any N, M0) * Inflammatory breast cancer (T4d, any N, M0) * Staging evaluation: * History and physical exam, cbc, chemistry profile * CT Chest/Abdomen/Pelvis and a bone scan or PET/CT as needed * Diagnosis of invasive adenocarcinoma made by core needle biopsy * Breast cancer determined to be: * Confirmed HER2-positive : (ASCO CAP guidelines, 10/7/2013) * IHC 3+ based on circumferential membrane staining that is complete, intense * ISH positive based on: * Single probe average HER2 copy number ≥ 6 signals/cell * Dual probe HER2/CEP 17 ratio ≥ 2.0 with an average HER2 copy number ≥ 4.0 signals/cell * Dual probe HER2/CEP 17 ratio ≥ 2.0, with an average HER2 copy number of \< 4.0 signals/cell * Dual probe HER2/CEP 17 ratio \< 2.0 with the average HER2 copy number of ≥ 6.0 signals/cell * any ER or PR receptor status * LVEF assessment by echocardiogram within 30 days of initiation; EF of ≥ 55% considered normal. * Normal troponin I level at baseline * Blood counts must meet the following criteria: * ANC greater than or equal to 1500/mm3 * Platelet count greater than or equal to 100,000/mm3 * Hemoglobin greater than or equal to 10 g/dL * Serum creatinine less than or equal 2.5 mg/100ml * Adequate hepatic function by these criteria: total bilirubin must be less than or equal to 1.5 x the ULN for the lab unless the patient has a bilirubin elevation great than the ULN to 1.5 x ULN due to Gilbert's disease or similar syndrome involving slow conjugation of bilirubin; and alkaline phosphatase must be less than or equal to 2.5 x ULN for the lab; and AST must be less than or equal to 1.5 x ULN for the lab. Both alkaline phosphatase and AST may not both be greater than the ULN. * Patients with AST or alkaline phosphatase \> ULN are eligible for inclusion in the study if liver imaging (CT, MRI, PET-CT or PET scan) performed within 90 days prior to randomization does not demonstrate metastatic disease and the requirements are met as above * Patients with alkaline phosphatase that is \> ULN but less than or equal to 2.5 x ULN or unexplained bone pain are eligible for inclusion in the study if a bone scan, PET-CT scan, or PET scan performed within 90 days prior to randomization does not demonstrate metastatic disease. Exclusion Criteria: Patients with a history of decompensated congestive heart failure or an EF \< 55% will be excluded • Cardiac disease that would preclude the use of the drugs included in the above regimens. This includes but is not confined to: * Active cardiac disease: * angina pectoris requiring the use of anti-anginal medication; * ventricular arrhythmias except for benign premature ventricular contractions controlled by medication; * conduction abnormality requiring a pacemaker; * supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication; and * clinically significant valvular disease * symptomatic pericarditis * pulmonary hypertension * History of cardiac disease: * myocardial infarction; * congestive heart failure; or * cardiomyopathy