Combination Chemotherapy With or Without Colony-stimulating Factors in Treating Women With Breast Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the breast that is potentially curable

  * T0-4 (dermal involvement on pathology assessment only), N0-2, M0
  * No clinical T4 disease
* Previously treated with one of the following:

  * Total mastectomy and level II axillary node dissection
  * Partial mastectomy and level II axillary node dissection with planned breast radiotherapy after completion of adjuvant chemotherapy regimen\*
  * Patients with a positive sentinel node biopsy must undergo level II axillary node dissection or sufficient nodal sampling
  * If microscopic residual in situ or invasive disease is present at total or partial mastectomy margins, planned radiotherapy must also include a boost to the tumor bed
* No residual tumor in the axilla after dissection
* Axillary node positive

  * Negative nodes allowed if the tumor is ≥ 1 cm and 1 or more of the following criteria defining high-risk node-negative disease are met:

    * Histological grade III or,
    * Estrogen receptor negative or,
    * Lymphatic/vascular invasion
* Hormone receptor status:

  * Estrogen receptor status known

PATIENT CHARACTERISTICS:

Age:

* 60 and under

Sex:

* Female

Menopausal status:

* Pre- or postmenopausal

Performance status:

* ECOG 0-2

Life expectancy:

* At least 5 years

Hematopoietic:

* WBC ≥ 3,000/mm\^3
* Platelet count ≥ 100,000/mm\^3

Hepatic:

* Bilirubin ≤ 1.5 times upper limit of normal (ULN)

Renal:

* Creatinine ≤ 1.5 times ULN

Cardiovascular:

* LVEF ≥ limit of normal by MUGA or echocardiogram
* No arrhythmia requiring ongoing treatment
* No congestive heart failure
* No documented coronary artery disease

Other:

* No other malignancy except:

  * Adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
  * Ductal or lobular carcinoma in situ that has been curatively treated by surgery alone
  * Other prior malignancies (except breast cancer) curatively treated more than 5 years prior to study entry
* No serious underlying medical illness or psychiatric or addictive disorder that would preclude study compliance
* No known hypersensitivity to E. coli-derived products, mammalian-cell derived products, or any study agents
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective non-hormonal contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* No prior immunotherapy for breast cancer
* No concurrent pegfilgrastim or darbepoetin alfa (Arm II)

  * Allowed on arms 1 and 3 if medically necessary

Chemotherapy:

* No prior chemotherapy for breast cancer

Endocrine therapy:

* No prior hormonal therapy for breast cancer
* No concurrent hormone replacement therapy
* No concurrent selective estrogen-receptor modulators (e.g., raloxifene for the treatment or prevention of osteoporosis)
* No concurrent oral contraceptives (i.e., birth control pills)
* No other concurrent aromatase inhibitors

Radiotherapy:

* See Disease Characteristics
* No prior radiotherapy for breast cancer

Surgery:

* See Disease Characteristics
* No more than 12 weeks since prior total or partial mastectomy (including re-excision of margins)

Other:

* At least 30 days since prior investigational drugs
* No other concurrent investigational drugs
* Concurrent bisphosphonates for the treatment or prevention of osteoporosis allowed