Preoperative Cisplatin and Bevacizumab in ER-, PR-, HER2 Negative Breast Cancer

- To prepare for surgery, a small "clip" will be placed into the tumor area so that the
surgeon can locate the site of the tumor at the time of surgery. This is a standard
procedure for breast cancer.

- The study drugs will be given in four 3-week cycles (about 3 months). Participants will
come into the clinic each day they receive study treatment intravenously. Cisplatin will
be given on day one of the treatment cycle (once every 3 weeks) for four cycles.
Bevacizumab will be given on day one of the treatment cycle for three cycles.

- On day one of each 3-week cycle a physical exam, routine blood tests and urine test will
be performed. 7-8 days after chemotherapy, blood tests and a hearing test will be
performed. A preoperative study visit will take place 7-10 days before surgery and a
physical exam, routine blood tests, Electrocardiogram (EKG) and an Magnetic Resonance
Imaging (MRI) of the breast will be performed.

- Surgery to remove the tumor will occur at least three weeks after the last dose of
cisplatin and is considered standard of care.

- Postoperative chemotherapy will begin at least three weeks after surgery. Everyone on
the research study will receive four 2-week cycles of doxorubicin and cyclophosphamide
plus bevacizumab. After the 8 weeks, the doctor will decide which of the following two
treatment regimens the participant will receive: Bevacizumab for four 2-week cycles
(once every two weeks) or; Paclitaxel plus bevacizumab for four 2-week cycles (once
every two weeks).

- At the end of the postoperative chemotherapy, the participant will return to the clinic
for a medical history, physical exam, vital signs, performance status, routine blood
tests, multiple gated acquisition scan (MUGA) or Echocardiogram Scans, and a hearing
test.

Inclusion Criteria:

- All tumors must be ER-, PR- and HER2-negative

- Clinical stage T2 or T3, N0-3, M0. Subjects with inflammatory breast cancer are not
eligible

- For subjects with clinically negative axilla, a sentinel lymph node biopsy will be
performed either up front or after preoperative therapy at the discretion of the
subject's physicians; for subjects with a clinically positive axilla, a needle
aspiration or core biopsy will be performed to confirm the presence of metastatic
disease in the lymph nodes.

- 18 years of age or older

- Performance status (PS) of 0 or 1

- Use of an effective means of contraception in subjects of child-bearing potential

- Normal organ function as described in the protocol

Exclusion Criteria:

- Any prior cytotoxic chemotherapy or radiation for the current breast cancer

- HER2-negative ipsilateral breast recurrence, unless prior treatment consisted of
excision alone for ductal carcinoma in situ (DCIS)or breast-conserving treatment and
hormonal therapy for DCIS or invasive cancer

- Life expectancy of less than 12 weeks

- Current, recent, or planned participation in an experimental durg study other than a
Genentech-sponsored bevacizumab cancer study

- Renal dysfunction for which exposure to cisplatin would require dose modifications

- Steroid dependent asthma

- Peripheral neuropathy of any etiology that exceeds grade 1

- Uncontrolled diabetes

- History of malignancy treated without curative intent

- Any other pre-existing medical condition that would represent toxicity in excess of
grade 1

- Inadequately controlled hypertension

- Any prior history of hypertensive crisis or hypertensive encephalopathy

- New York Heart Association (NYHA) Grade II or greater congestive hear failure

- History of myocardial infarction or unstable angina within 12 months prior to study
enrollment

- Any history of stroke or transient ischemic attack at any time

- Known central nervous system (CNS) disease

- Significant vascular disease

- Symptomatic peripheral vascular disease

- Evidence of bleeding diathesis or coagulopathy

- Major surgical procedure, open biopsy, or significant traumatic injury within 21 days
prior to study enrollment

- History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess
within 6 months prior to study enrollment

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

- Proteinuria at screening

- Known hypersensitivity to any component of bevacizumab

- Pregnant or lactating