Neoadjuvant treatment for breast cancer refers to systemic treatment of the whole body before planned surgery or local treatment of surgery plus radiotherapy for primary breast cancer patients with no distant metastases detected. Commonly speaking, it means systemic treatment (including chemotherapy, targeted therapy, endocrine therapy) before surgery, with the aim of reducing tumor size and stage, so that inoperable patients can be operated and non-breast-conserving patients can be breast-conserving, and at the same time, the sensitivity of tumor to drugs can be judged to guide the subsequent medication, which suggests a better prognosis for sensitive patients, while those who are not sensitive need intensive postoperative treatment to improve the prognosis. 1. Neoadjuvant treatment for breast cancer 1) 1) Tumor larger than 5 cm 2) positive axillary lymph nodes 3) Her2 positive 4) triple negative 5) breast-conserving tendency 2) Preparation before neoadjuvant treatment 1) Tumor information collection (1) blood, urine routine, biochemical examination, electrocardiogram, chest CT, ultrasound (breast and drainage area, abdomen and pelvis, etc.), mammography and MR; patients with locally advanced breast cancer or inflammatory breast cancer also need additional whole-body bone (2) The whole body bone scan, cranial MR scan + enhancement, PET-CT can also be considered, but not routinely recommended. (2) Hollow-core needle biopsy or vacuum-assisted biopsy must be performed on the primary site of breast before treatment to obtain histological pathology and clarify the histological diagnosis and immunohistochemical examination. (3) If breast cancer metastasis is suspected in enlarged regional lymph nodes, pathological confirmation should be obtained by fine needle or hollow needle aspiration as much as possible. 2) Tumor localization and labeling 3) Physician-patient communication Physicians should instruct patients on psychological counseling, fertility counseling and genetic counseling, and communicate to patients and family members the purpose, protocol, number of cycles of preoperative neoadjuvant therapy and possible disease stabilization or progression requiring changes in treatment regimen The patient and family should be informed of the purpose of preoperative neoadjuvant therapy, the protocol, the number of cycles, and the possibility of disease stabilization or progression requiring a change in treatment plan. (1) Her2-negative breast cancer The preferred regimen is anthracycline combined with paclitaxel, such as TA/EC regimen (docetaxel + doxorubicin or epirubicin + cyclophosphamide); optional regimens are TP (docetaxel + cisplatin) and A/EC-T (doxorubicin or epirubicin + cyclophosphamide sequential docetaxel or paclitaxel). (2) Her2-positive breast cancer, trastuzumab + pertuzumab combination chemotherapy is recommended as the preferred regimen, such as TCbHP (docetaxel + carboplatin + trastuzumab + pertuzumab) and THP (docetaxel + trastuzumab + pertuzumab); TCbH (docetaxel + carboplatin + trastuzumab) is optional if pertuzumab is not available. 3) Luminal type with liver metastasis accounts for 25% of the cases, and the prognosis of HR+/Her2- is poor. CDK4/6 inhibitor paxil combined with endocrine therapy.