Exemestane (Aromasine) + Tamoxifen - Breast Neo-Adjuvant

Inclusion criteria

• Breast cancer histologically proven by a 14 G or 16 G micro-biopsy to have confirmation of the diagnosis, evaluation histology prognosis grade, hormone receptors and to obtain a sample for the study of biological factors.
• Menopausal patients as defined as follows:

• Natural menopause >= 1 year, or
• Surgical ovariectomy.
• T unilateral tumor> 3 cm, N 1-2, M0 or M +, non-inflammatory.
• Hormone receptor positive. RE positive or PR positive with histochemical technique (+ 10% of cells express the receptor)
• No previous treatment of the disease by chemotherapy, hormone therapy, surgery or radiotherapy. Discontinuation of replacement therapy of menopause for at least 1 month
• Age>= 60 years
• Evaluable disease
• Performance Status <= 2
• Biological function using the following criteria:

• neutrophils >= 2.10E9 / l,
• Platelets> = 100.10E9 / l,
• Hemoglobin> = 10 g / dl,
• Creatinine <= 1.5 x upper normal,
• Total bilirubin <= 1.25 x the upper normal
• Transaminases (AST and ALT) <= 1.5 x upper normal,
• Alkaline phosphatase <= 2.5 x upper normal.
• Cardiac Function: electrocardiogram (ECG) normal.
• Signed written consent before any procedure related to the study.

Exclusion criteria

• Men
• Non Menopausal Patients
• Patients with hormone receptor negative: PR- and RE -
• Contra-indication to anti-estrogens (risk thrombi arteria)
• Tumor <3 cm operable
• Tumor inflammatory T4d (PEV 2 or 3).
• Extensive hepatic lesions (> 1 / 3 of liver volume)
• Uncontrolled cardiac disease such as angina, congestive heart failure, or arrhythmia requiring medical treatment or history of myocardial infarction within 3 months before.
• History of cancer except skin cancer and basal cell cancer in situ of the cervix (a contralateral breast cancer had been no systemic treatment will be admitted).
• Chronic diseases (somatic or psychiatric) in poor prognosis.
• Patients who for reasons of family, social, geographical or psychological can not be followed properly.
• Patients under law protection