How to individualize adjuvant chemotherapy for breast cancer? Chemotherapy and endocrine therapy are the left and right arms of breast cancer treatment, and postoperative adjuvant chemotherapy plays an important role in the adjuvant treatment of breast cancer. The majority of patients need adjuvant chemotherapy, while only patients with low risk and good pathology can receive adjuvant endocrine therapy alone without adjuvant chemotherapy. Traditionally, clinicopathological factors include: age, tumor size, tissue grading, vascular tumor thrombus, axillary lymph nodes, ER, PR, HER2, and in the past, the risk level was classified according to the above factors to determine the choice of adjuvant chemotherapy. However, in recent years, breast cancer has entered the era of categorized treatment based on molecular typing according to the biological characteristics of the tumor, and the selection of chemotherapy and regimen should be considered comprehensively based on molecular typing combined with risk grading. Anthracyclines and paclitaxel drugs still have an important cornerstone position in adjuvant chemotherapy. The commonly used adjuvant chemotherapy regimens include TC, AC/EC, AC-T, TAC, AC-wP, etc. What are the appropriate population and recommended regimens for neoadjuvant chemotherapy? The indications for neoadjuvant chemotherapy are still controversial. The absolute indications are locally advanced breast cancer, including those patients whose tumors are too large for surgery and can be surgically removed with neoadjuvant chemotherapy. The absolute indications are for locally advanced breast cancer, including patients whose tumors are too large for surgery and can be surgically removed with neoadjuvant chemotherapy, and for patients whose tumors are too large for breast-conserving surgery. The relative indications also include patients with poor molecular typing who require adjuvant chemotherapy after surgery, and in principle, neoadjuvant chemotherapy can be considered. For example, patients who are hormone receptor negative or Her-2 positive may be considered for neoadjuvant chemotherapy even if the breast mass is not large or the axillary lymph nodes are negative. Anthracyclines and paclitaxel have an important place in neoadjuvant chemotherapy, and all currently effective regimens of adjuvant chemotherapy can be recommended as neoadjuvant chemotherapy regimens, with the addition of trastuzumab recommended in neoadjuvant therapy if the patient is Her-2 positive. Late stage breast cancer treatment: fine water, prolong life The goal of late stage breast cancer treatment is mainly to relieve symptoms, improve quality of life, and prolong survival. The formulation of the regimen must balance the relationship between efficacy and toxicity, and even consider the economics or other comprehensive factors. As a chronic disease, it is impossible to be cured, therefore, the concept of long flow and prolonged life is the same as long-distance running, where endurance is somehow more important than speed, and we must pay more attention to quality of life and consider patients’ personal wishes.