Abstract： Breast cancer has a high incidence and mortality rate among women,ranking at the forefront of female tumors.Despite the confirmed efficacy of neoadjuvant chemotherapy,drug resistance remains a major cause of treatment failure and a significant challenge in breast cancer therapy.This article focuses on elucidating various mechanisms of ac-tion and discusses recent advances in understanding the pathways that mediate resistance of breast cancer cells.Building on existing research on resistance mechanisms,the paper explores current strategies to reverse resistance to neoadjuvant chemotherapy in breast cancer and analyzes existing predictive schemes for drug resistance in breast cancer cells,aiming to provide novel insights and strategies for overcoming resistance to neoadjuvant chemotherapy in breast cancer.