Inclusion Criteria:

- Female or male, age ≥ 18 years

- Pathologically confirmed invasive primary breast adenocarcinoma (except inflammatory
breast cancer, T4d) scheduled for taxane containing neoadjuvant systemic treatment
with/without palpable lymph nodes.

- Documented HER2 protein overexpression as determined by immunohistochemistry (IHC) 3+
or by demonstrated HER2/c-erbB2 gene amplification of the primary tumor by a local
laboratory.

- LVEF ≥ 55% measured by echocardiography or MUGA within 4 weeks before randomization

- ECOG Performance Status ≤ 1

- Able and willing to comply with scheduled visits, treatment plans, laboratory tests,
and other study procedures.

- Written Informed Consent

Exclusion Criteria:

Current Treatment

- Requirement for concurrent use of the antiviral agent sorivudine or chemically
related analogues, such as brivudine.

- Chronic daily treatment with corticosteroids excl. inhaled steroids.

- Chronic daily treatment with aspirin and aspirin analogs or clopidogrel

- Major surgical procedure, open biopsy or significant traumatic injury within 28 days
prior to randomization or anticipation of need for major surgery during the course of
study treatment

- Current or recent (within 30 days prior to randomization) treatment with another
investigational drug or participation in another investigational study.

Laboratory

- Inadequate bone marrow function

- Inadequate liver function

- Inadequate renal function

- Patients not receiving anticoagulant medication who have activated partial
thromboplastin time (aPTT) within 7 days prior to Day1 of the cycle 1.

Concomitant Conditions

- Other malignancy within the last 5 years before randomization except for curatively
treated carcinoma in situ of the cervix or non-melanomatous skin cancer

- Evidence of distant metastasis judged clinically and at least by chest-X-ray,
liver-sonography and bone scan. If there is any clinical suspicion of brain
metastasis, a CT-scan or MRI of the brain must be conducted within 4 weeks prior to
randomization.

- Serious concurrent disease which could affect compliance with the protocol or
interpretation of results, including, but not limited to:

- Active infection requiring i.v. antibiotics

- Uncontrolled hypertension

- Clinically significant history of cardiovascular disease as indicated by:
cerebrovascular accident or stroke; myocardial infarction; unstable angina; NYHA
Grade II or greater CHF; cardiac arrhythmia requiring medication; clinically
significant valvular heart disease.

- Dyspnea at rest necessitating supportive oxygen therapy or with significant
pleural effusions

- Poorly controlled diabetes mellitus

- History or evidence upon physical/neurological examination of CNS disease
unrelated to cancer (e.g. uncontrolled seizures) unless adequately treated with
standard medical therapy

- History or evidence of inherited bleeding diathesis or coagulopathy with the
risk of bleeding

- History of abdominal fistula, GI perforation, or intra-abdominal abscess within
6 months of randomization

- Serious non-healing wound, peptic ulcer, or bone fracture

- Clinically significant malabsorption syndrome, ulcerative colitis, disease
affecting GI function, resection of the stomach or small bowel, or inability to
take oral medication

- Uncorrected hypokalemia or hypomagnesemia

- Organ allografts requiring immunosuppressive therapy

- Evidence of any other disease, metabolic or psychological dysfunction, physical
examination finding, or clinical laboratory finding giving reasonable suspicion of a
disease or condition that contraindicates the use of an investigational drug, may
affect patient compliance with study routines, or place the patient at high risk from
treatment related complications.

- Known hypersensitivity to any of the study drugs/excipients.

- Hypersensitivity to Chinese hamster ovary cell products or other recombinant human or
humanized antibodies.

Other

- Pregnant, lactating females or women of childbearing potential without a negative
pregnancy test

- Fertile males or females of childbearing potential

- Patients not accessible for treatment or follow-up