Statement: Females aged between 18-25 with stable angina cannot be included in either the secondary trial or the primary trial.
Primary_evidence: Inclusion Criteria:   Women aged 45-69, according to the target age of the screening centres involved;   New invited women in mammography screening programme. Exclusion Criteria: None
Secondary_evidence: DISEASE CHARACTERISTICS:   Histologically or cytologically confirmed infiltrating breast cancer   Clinical evidence of metastatic disease   Measurable disease, defined as at least one measurable lesion per RECIST criteria   No non-measurable disease only, defined as all other lesions, including small lesions (longest diameter < 2 cm) and truly non-measurable lesions, including any of the following:   Bone lesions   Leptomeningeal disease   Ascites   Pleural/pericardial effusion   Inflammatory breast disease   Lymphangitis cutis/pulmonis   Abdominal masses that are not confirmed and followed by imaging techniques   Cystic lesions   Patients with HER-2/neu positive tumors, must have received prior treatment with trastuzumab (Herceptin®) or have a contraindication for trastuzumab   No evidence of active brain metastasis, including leptomeningeal involvement, on MRI or CT scan   CNS metastasis controlled by prior surgery and/or radiotherapy allowed   Must be asymptomatic for  2 months with no evidence of progression prior to study entry   Hormone receptor status not specified   PATIENT CHARACTERISTICS:   Menopausal status not specified   Life expectancy  12 weeks   ECOG performance status 0-1   ANC  1,500/mm³   Platelet count  100,000/mm³   Hemoglobin  9.0 g/dL   AST and ALT  2.5 times upper limit of normal (ULN)   Alkaline phosphatase  2.5 times ULN   Total bilirubin  1.5 times ULN   Creatinine  1.5 mg/dL   Urine protein:creatinine ratio < 1 or urinalysis < 1+ protein   Patients discovered to have  1+ proteinuria at baseline must demonstrate 24-hour urine protein < 1 g   Not pregnant or nursing   Negative pregnancy test   Fertile patients must use effective contraception during and for 30 days after completion of study therapy   Able to complete questionnaires alone or with assistance   No peripheral neuropathy > grade 1   No history of allergy or hypersensitivity to albumin-bound paclitaxel, paclitaxel, gemcitabine hydrochloride, bevacizumab, albumin, drug product excipients, or chemically similar agents   No stage III or IV invasive, non-breast malignancy within the past 5 years   No other active malignancy, except nonmelanoma skin cancer or carcinoma in situ of the cervix   Patient must not be receiving other specific treatment for a prior malignancy   No uncontrolled hypertension (i.e., blood pressure [BP] > 160/90 mm Hg on  2 occasions at least 5 minutes apart)   Patients who have recently started or adjusted antihypertensive medications are eligible providing that BP is < 140/90 mm Hg on any new regimen for  3 different observations in  14 days   No bleeding diathesis or uncontrolled coagulopathy   No hemoptysis within the past 6 months   No prior arterial or venous thrombosis within the past 12 months   No history of cerebrovascular accident   No history of hypertensive crisis or hypertensive encephalopathy   No abdominal fistula or gastrointestinal perforation within the past 6 months   No serious non-healing wound, ulcer, or fracture   No clinically significant cardiac disease, defined as any of the following:   Congestive heart failure   Symptomatic coronary artery disease   Unstable angina   Cardiac arrhythmias not well controlled with medication   Myocardial infarction within the past 12 months   No comorbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for study entry or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens   PRIOR CONCURRENT THERAPY:   See Disease Characteristics   No prior chemotherapy for metastatic disease   May have received one prior adjuvant chemotherapy regimen   Prior neoadjuvant chemotherapy allowed   More than 6 months since prior adjuvant or neoadjuvant taxane (i.e., docetaxel or paclitaxel) therapy   Prior hormonal therapy in either adjuvant or metastatic setting allowed   More than 4 weeks since prior radiotherapy (except if to a non-target lesion only, or single dose radiation for palliation)   Prior radiotherapy to a target lesion is allowed provided there has been clear progression of the lesion since radiotherapy was completed   More than 4 weeks since prior cytotoxic chemotherapeutic agent or investigational drug   More than 2 weeks since prior and no concurrent acetylsalicylic acid, anticoagulants, or thrombolytic agents (except for once-daily 81 mg acetylsalicylic acid)   More than 6 weeks since prior major surgery, chemotherapy, or immunologic therapy   More than 1 week since prior minor surgery (e.g., core biopsy)   Placement of a vascular access device within 7 days is allowed   More than 3 months since prior neurosurgery   No concurrent treatment in a different clinical study in which investigational procedures are performed or investigational therapies are administered   Trials related to symptom management (Cancer Control) which do not employ hormonal treatments or treatments that may block the path of the targeted agents used in this study may be allowed