Cyclophosphamide, Methotrexate, and Fluorouracil, With or Without Epirubicin Hydrochloride, in Treating Women Who Have Undergone Surgery for Breast Cancer (Group III Closed to New Patients as of 12/7/2009)

DISEASE CHARACTERISTICS:

* Histologically confirmed breast cancer

  * Underwent radical mastectomy, guadrantectomy, or tumorectomy with axillary node dissection within the past 4-6 weeks
  * Biologically aggressive disease
  * At least 10 lymph nodes removed

    * Node-negative (\> 1 cm, or \> 2 cm if histology is favorable, esp. tubular carcinoma and/or prevalent intraductal component \> 50%) tumors OR node-positive (1-3) tumors, meeting the following criteria:

      * High thymidine-labeling index (\> 3%)
      * Poorly differentiated tumor (grade III)
      * High S-phase fraction (\> 10% by flow cytometry)
      * High Ki67/MIB1 expression (\< 20%)
* No bilateral breast cancer
* No T4a, inoperable T4b, T4c, or T4d disease
* Any estrogen receptor status (positive, negative, unknown)
* No distant metastases

PATIENT CHARACTERISTICS:

* Any menopause status
* WBC ≥ 3,500/mL
* ANC ≥ 1,500/mL
* Platelet count ≥ 120,000/mL
* AST and ALT ≤ 1.5 times upper limit of normal (ULN)
* Creatinine ≤ 1.5 mg/mL
* Bilirubin ≤ 1.5 times ULN
* Not pregnant
* Geographically accessible for follow-up
* No prior breast cancer and/or other cancer except for carcinoma in situ of the cervix or basal cell skin cancer treated with radical intent
* No significant alterations in cardiovascular function
* No serious psychiatric disorders
* No impaired renal or liver function

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics