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PURPOSE The objective of this study was to test the efficacy and toxicity of adriamycin plus docetaxel as primary chemotherapy for women with locally advanced breast carcinoma, including patients with inflammatory breast cancer. METHODS: From 2001, April to 2003, July, 18 patients with locally advanced breast cancer were treated with Adriamycin (50 mg/m2; intravenous bolus) followed by docetaxel (75 mg/m2; 1-hour intravenous infusion) on day of each cycle for four cycles. RESULTS: Two of 18 patients (11.8%) had inflammatory breast carcinoma. 17 (94.4%) patients underwent surgery. 14 (82.4%) patients had clinical responses, of them, two (11.8%) patients had complete clinical response in primary tumor. One case showed a pathologic complete response. In the lymph node response, four (23.6%) patients had clinical complete responses and 11 (64.7%) patients had partial clinical responses. Grade 3 or 4 neutropenia was recorded in 21.7% (21/97 cycles) and febrile neutropenia was recorded in 13.4% (13/97 cycles). Grade 3 or 4 anemia was recorded in 4.2% (4/97 cycles), but there was no severe thrombocytopenia. Other side effects were diarrhea, oral mucositis and mild emesis. CONCLUSION: Neoadjuvant chemotherapy with adriamycin plus docetaxel was a feasible and effective threatment in an unfavorable series of patients with locally advanced breast cancer including patients with inflammatory breast cancer.