Primary chemotherapy is increasingly used in patients with large operable breast cancer. Docetaxel and epirubicin are the most active agents in breast cancer treatment. Purpose: To evaluate clinical response rate, breast conserving surgery and pathological response rate in patients with large oper­able breast cancer treated with docetaxel followed by docetaxel and epirubicin as primary chemotherapy. Patients and Methods: Patients with operable breast cancer more than 3 cm in the longest diameter with T2NO, T2Nl and T3NO disease were enrolled. Patients were treated with three cycles of docetaxel 100 mg/m² followed by three cycles of docetaxel 75 mg/m² and epirubicin 90 mg/m² prior to surgery. Results: Sixty-five patients were enrolled between 09/2002 and 12/2005. The median age was 48.9 years and 72.3% were pre­menopausal. Median tumour size was 4.26 cm, 10.8% were T3 tumours and 38.5% had clinical positive lymph nodes. Of the tumours 58.5% were grade 1/2, 33.9% ER positive and 21.5% c-erb negative. All six cycles were administered to 62 patients; six cycles were delayed and five had dose reductions. Complete clinical response occurred in 41.5% of patients and partial response in 49.2%. Breast conserving surgery was performed in 30% of patients however it was feasible in 57%. Complete pathological response occurred in both primary tumour and nodes in 28%, and in 34% just in the primary tumour. Nine percent of cases had neutropenia and 7.7% febrile neutropenia, and two cases had a hypersensitivity reaction to docetaxel. One associated treatment death occurred. Conclusion: Docetaxel followed by epirubicin and docetaxel as primary chemotherapy results in a high clinical and pathological response rate. The majority of adverse events were predictable and manageable.