Statement: Patients have received prior radiation treatment, to treat the current breast cancer, in the last two 2 weeks before study entry are eligible for the primary trial but excluded from the secondary trial.
Primary_evidence: Inclusion Criteria:   Females  18 years of age   Histologically confirmed breast cancer that is HER2/neu positive (3+ by IHC or FISH +) and evidence of metastatic disease. Tumor may be of any estrogen and progesterone receptor type   Measurable disease by RECIST and an ECOG  2   Patients with known evidence of brain metastases are eligible if they are asymptomatic and have completed all therapy (surgery, radiotherapy, and/or steroids)   Baseline LVEF value within the institutional normal range   Any number of prior hormonal therapy treatments in the adjuvant setting or for metastatic disease. A subject must have progressed on hormonal therapy and all hormonal therapy (including birth control pills) must be discontinued at study entry.   Prior chemotherapy in the adjuvant setting and up to one prior chemotherapy regimen for metastatic disease is allowed.   Patients may have received one prior trastuzumab/chemotherapy containing regimen or prior single agent trastuzumab.   Prior radiation therapy in the adjuvant setting or for metastatic disease, provided it was not to the only site of evaluable disease.   All prior chemotherapy, trastuzumab and radiation therapy should be completed > 2 weeks before enrollment.   Patients receiving bisphosphonate therapy are eligible. However, if bisphosphonate were started within < 2 months prior to enrollment, the bone lesions will not be evaluated for response and the patient must have another site of metastatic disease that is either measurable or evaluable for response.   Patients must have recovered from toxicities due to prior therapy.   Lab values in accordance with the protocol   Patients must be nonpregnant and nonlactating. Patients of childbearing potential must implement an effective method of contraception during the study (birth control pills are not allowed). Exclusion Criteria:   Bone only disease are ineligible   Patients who received more than 1 prior chemotherapy regimen for metastatic disease are ineligible.   Patients with a history of other cancers except curatively-treated carcinoma of the cervix in situ or non-melanomatous skin cancer.   Active serious infection or other underlying medical condition that would impair their ability to receive protocol treatment.   Uncontrolled nervous system metastases   Dementia or significantly altered mental status that would interfere with proper consenting.   Receiving other investigational therapy.
Secondary_evidence: 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