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BACKGROUND	Neoadjuvant treatment provides a unique opportunity to evaluate individual tumor sensitivity .
BACKGROUND	This study evaluated whether a response-guided strategy could improve clinical outcome compared with a standard treatment .
METHODS	Overall , 264 previously untreated stage II-III operable breast cancer patients were randomized to receive either standard treatment ( arm A , n = 131 ) , consisting of fluorouracil , epirubicin , and cyclophosphamide ( FEC100 : 500 , 100 , and 500 mg/m ( 2 ) , respectively , for 3 cycles ) followed by docetaxel ( 100 mg/m ( 2 ) for 3 cycles ) , or adapted treatment ( arm B , n = 133 ) , beginning with 2 cycles of FEC100 and switching to docetaxel if tumor size decreased by < 30 % after 2 cycles or < 50 % after 4 cycles of FEC100 ( ultrasound assessments according to World Health Organization criteria ) .
METHODS	Otherwise , FEC100 was given for six cycles before surgery .
METHODS	Intent-to-treat analysis was performed .
RESULTS	Similar results were observed for clinical response ( objective response was 54 % vs 56 % , p = .18 ) , breast conservation surgery ( BCS ; 67 % vs 68 % , p = .97 ) , and pathological complete response rate ( Chevallier classification : 14 % vs 11 % , p = .68 ; Statloff classification : 16 % vs 13 % , p = .82 ) between arms A and B. Similar toxicities were observed , even with unbalanced numbers of FEC100 and docetaxel courses .
CONCLUSIONS	Adapted and standard treatments had similar results in terms of tumor response , BCS rate , and tolerability .
CONCLUSIONS	Further survival outcome data are expected .

