Breast cancer is the most common malignancy in the world and in India. The five-year survival of breast cancer today is upward of 90%. Chemotherapy plays a major role in the management of breast cancer and has added benefit to surgery alone. Chemotherapy was initially only administered after surgery, serving as an adjuvant therapy to reduce the risk of cancer recurrence. Eventually, it has moved to the neoadjuvant setting, i.e., before the surgery and removal of the tumor. The choice of chemotherapy drugs and regimens depends on various factors, including the stage of the cancer, the specific characteristics of the tumor, and the patient’s overall health. Over the past decades, breast cancer has seen a multitude of advancements with targeted therapy and hormonal agents. Despite the challenges associated with side effects, the benefits of breast cancer chemotherapy, both in terms of increasing survival rates and improving the quality of life for patients, underscore its critical role in the multidisciplinary approach to managing this complex and widespread disease. This chapter briefs about how breast cancer evolved from a surgeon-dominant malignancy to a cancer requiring multidisciplinary tumor boards with the integration of chemotherapy.