Inclusion Criteria:

- Locally advanced breast cancer diagnosed by guided core biopsy

- T > 2 cm (any N), or any T and node positive (needle biopsy is required)

- Non-metastatic disease assessed by computed tomography and bone scintigraphy

- Histological grade 2 and Ki67 > 15% or

- Histological grade 3 or

- Any triple negative (TN) or

- Inflammatory breast cancer (IBC)

- Normal left ventricular ejection fraction (LVEF)

- HER2-negative disease

Exclusion Criteria:

- Another malignancy within the last 5 years (except curatively treated skin carcinoma,
in situ cervix carcinoma, in situ ductal carcinoma of the breast, or in situ lobular
carcinoma of the breast)

- Clinically significant comorbidities as cardiovascular diseases, chronic obstructive
pulmonary disease (COPD), renal or liver failure, psychiatric disorders

- LVEF value below institutional limits of normal

- Predominant lobular carcinoma histology

- Grade 1 tumors

- Detected or suspicious distant metastasis

- Neutrophils less than 1,500/µL, platelets less than 100,000/µL, hemoglobin less than
10 g/dL, AST more than 2.5x upper limit of normal (ULN), total bilirubin more than
ULN, alkaline phosphatase more than 1.5x ULN

- Male sex

- HER2-positive breast cancer