Abstract: Objective:To investigate the feasibility of breast-conserving therapy (BCT) for locally advanced breast can -cer (LABC) after neoadjuvant chemotherapy (NAC). Methods:A total of522 patients with locally advanced breast cancer were collected between January1996and December 2006and were randomly assigned into the neoadjuvant chemothera -py group (T group) and the control group (C group). Breast-conserving surgery and total mastectomy (MT) were electively performed for T group depending on the imaging and pathology after 4-6 cycles of neoadjuvant chemotherapy consisting of FEC ( 5-Fluorouracil, Epirubicin, Cyclophosphamide) or TEC (Docetaxel, Epirubicin, Cyclophosphamide), whereas total mastectomy was performed for C group. The response rate of the neoadjuvant chemotherapy and its effect on the surgery modality for locally advanced breast cancer was analyzed, and the local recurrence rate, metastatic rate, overall survival rate, disease-free survival rate, and cosmetic results of patients treated with breast-conserving therapy were also studied compared with those who underwent total mastectomy in T group and C group. Results: In T group, the response rate was 89.19% (231 /259 ), and 82.20% (217 /264 ) patients became eligible for breast-conserving therapy by imaging reevaluation after neoadjuvant chemotherapy. Eighty-five patients underwent breast conserving surgery, and the rate of satisfactory cos-metic results was 92.94%. Follow-up for36~166 months (median,67.4 months) showed no statistical  significance in recur-rence rate, metastatic rate, overall survival rate and disease-free survival rate among patients treated with BCT in T group, patients treated with MT in T group, and those in C group. Conclusion:Breast-conserving therapy offers satisfactory effects on patients with locally advanced breast cancer previously treated with neoadjuvant chemotherapy. Imaging and pathologi-cal examination are crucial for selection of appropriate surgical treatment.