In which of the following neo-adjuvant chemotherapy is not used?

Breast cancer Treatment A. Early invasive Breast cancer (Stage I, IIA, IIB) Mastectomy +Axillary LN status assessment or BCT + Axillary LN status assessment + If sentinel LN cannot be identified or found to harbour metastatic disease, axillary LN dissection (Level I + II) should be done Indications of adjuvant Chemotherapy LN postive Tumor >1 cm LN negative, >0.5 cm with adverse prognostic factors Blood vessel or lymph vessel invasion High nuclear or histologic grade Her-2-neu over expression Negative hormone receptor status B. Locally Advanced breast cancer (Stage IIIA, IIIB, IIIC) Neoadjuvant chemotherapy + MRM + Adjuvant BCT for IIIA with N1 with patients who achieve good response to Neoadjuvant chemotherapy Systemic chemotherapy + radiotherapy are indicated in treatment of grossly involved internal mammary nodes (N3b) C. Distant metastasis (Stage IV) Prolong survival and improve quality of life Hormonal therapies are preferred to cytotoxic therapy as it is associated with minimal toxicity Ref: Sabiston 20th edition Pgno : 851-855