Patients suffering from breast cancer often go through a series of psychological change process at the earliest detection, from initial doubt in the diagnosis, to gradual belief in the diagnosis, to irritability and depression, but almost all of them eventually puff up their chests and actively seek surgical treatment. Sometimes, however, doctors are instead reluctant to operate as early as possible and recommend chemotherapy before surgery, leaving many patients feeling doubtful, anxious, and even resistant. As a result, some patients bear the side effects of chemotherapy while suffering the internal torment of looking forward to early surgery. In fact, if you understand the purpose and meaning of this treatment, you may not need to suffer both physically and emotionally, and you can face it openly for better treatment results. Pre-surgical chemotherapy is called “neoadjuvant chemotherapy”, sometimes called “initial chemotherapy” or “induction chemotherapy”. This treatment first appeared in the 1970s and was originally designed to allow inoperable patients to have their breast tumors reduced in size through chemotherapy to regain access to radical surgery. This goal remains the primary purpose of neoadjuvant chemotherapy and has become the most standardized treatment for locally advanced breast cancer and inflammatory breast cancer. As medical advances have affirmed and welcomed breast-preserving surgery, the role of neoadjuvant chemotherapy has expanded. Some patients have already large breast masses at the time of initial diagnosis, and these patients lose the opportunity of breast-conserving surgery even if they can be radically removed; or even if they can barely undergo breast-conserving surgery, the postoperative breast shape is severely deformed and does not achieve aesthetic results. For these patients, if neoadjuvant chemotherapy is administered before surgery, the breast tumor will shrink significantly or even disappear, and then the patient will have a chance to preserve the breast. Therefore, another important purpose of neoadjuvant chemotherapy is to achieve success rate of breast-conserving surgery for patients with large lumps. Of course, there are also some breast cancers that are particularly malignant and metastasize quickly, and some patients are even found to have metastases during the postoperative recovery period. These patients are poorly treated with surgery, and systemic control with chemotherapy is the first choice for these patients, and these patients are now the beneficiaries of neoadjuvant chemotherapy. Systemic control of the tumor through chemotherapy first, to avoid bloodstream metastasis, and then wait for good systemic control before seeking to remove the local tumor of the breast to further improve the treatment effect. Neoadjuvant chemotherapy also has a collateral role in visually judging the efficacy of chemotherapy and guiding postoperative chemotherapy. For chemotherapy in pre-surgical patients, since the tumor has not been removed, it is possible to visually determine the efficacy of the chemotherapy regimen for the patient by measuring the tumor size. For post-operative chemotherapy, since there is no tumor to visually determine the efficacy, the selection of chemotherapy drugs and regimens carries a certain degree of uncertainty. The visual efficacy of preoperative neoadjuvant chemotherapy can precisely guide the selection of postoperative chemotherapy. Because of the above purposes, we have some requirements for neoadjuvant chemotherapy. First is to strictly grasp the applicable population, not all breast cancer patients are suitable for neoadjuvant chemotherapy, which needs to be carefully selected by specialists based on multiple factors such as the patient’s disease stage, biological characteristics, and physical status. Secondly, the choice of neoadjuvant chemotherapy regimen should be as efficient as possible, even combined with molecular targeted drugs. Finally, once neoadjuvant chemotherapy is started, we should stop being anxious and impatient, because the efficacy of chemotherapy is not immediate. Generally, the cycle of neoadjuvant chemotherapy is 4-6 cycles, even up to 8 cycles, but of course, if no effect is found during the treatment, the treatment plan should be changed in time. Breast cancer emphasizes comprehensive treatment and requires team service, which requires the collaboration of several departments such as breast surgery, medical oncology, radiotherapy, diagnostic imaging, pathology, etc., and the cooperation of doctors, patients and their families. Through comprehensive treatment, the current treatment effect of breast cancer is significantly higher than most other tumors, but there is still room for further improvement, and we hope that one day we will be able to completely cure breast cancer.