Patients with resected breast cancer involving four or more ipsilateral axillary lymph nodes were treated with nine cycles of chemotherapy, using 14-day intertreatment intervals. The first three treatments consisted of doxorubicin 90 mg/m2, given by intravenous push; the second three treatments consisted of paclitaxel 250 mg/m2, given as a 24-hour infusion (Taxol; Bristol-Myers Squibb, Princeton, NJ, supplied by the National Cancer Institute, Bethesda, MD); and the third three treatments consisted of cyclophosphamide 3.0 g/m2, given as a 1-hour infusion
All doses were given with subcutaneous injections of 5 microg/kg granulocyte colony-stimulating factor on days 3 through 10. Amenorrheic patients with hormone receptor-positive tumors received tamoxifen 20 mg/day for 5 years. Patients treated with breast conservation, those with 10 or more positive nodes, and those with tumors larger than 5 cm received radiotherapy. With cyclophosphamide, the use of mesna was permitted but not required.