Abstract : Anthracycline is commonly used in neoadjuvant chemotherapy for breast cancer, although not all patients benefit from the therapy. Studies suggest that expression of TOP2A associated with Anthracycline sensitivity. Purpose: To know the relationship between the profile of baseline TOP2A mRNA expression and chemotherapy response in locally advanced breast cancer. An observational study, thirty breast cancer tissue samples pre-chemotherapy treated using cyclophosphamide-doxorubicin-5fluorouracyl regiment. Detection of TOP2A mRNA expression using qRT-PCR techniques. Clinical response to neoadjuvant chemotherapy based on RECIST criteria. The mean value of TOP2A mRNA expression in breast cancer patient’s prechemotherapy was 9.753±2.755, range 4.470–13.810. The mean value of TOP2A mRNA expression in breast cancer patients which responsive to chemotherapy was 10.601±2.208. The mean value of TOP2A mRNA expression in breast cancer patients, which nonresponsive to chemotherapy, was 6.969±2.648. Mean difference was 3.632, significant with p-value =0.001(p<0.05). There is a positive correlation between TOP2A mRNA expression with the clinical response with a value of r =0.475; this correlation was significant with p-value=0.004 (p<0.05). This study found a correlation between the profile of baseline TOP2A mRNA expression with clinical response to neoadjuvant chemotherapy in breast cancer