Objective To explore the value of p53, Ki67, nm23 and epidermal growth factor receptor (EGFR) in the evaluation of the efficacy of neoadjuvant chemotherapy for locally advanced breast cancer. Methods From January 1, 2013 to March 31, 2018, 98 cases of locally advanced breast cancer in our hospital were selected as the research subjects. The changes of p53, Ki67, nm23 and EGFR before and after neoadjuvant chemotherapy and their relationship with clinical efficacy were detected. Results The positive expression of p53, Ki67 and EGFR after chemotherapy were all lower than those before chemotherapy, and the positive expression of nm23 was higher than that before chemotherapy, the difference was statistically significant (P<0. 05). The effective rate of p53 positive was lower than that of the negative ones, and the difference was statistically significant (P< 0. 05). The effective rates of Ki67 and nm23 positive were higher than that of negative ones, and the difference was statistically significant (P<0. 05). There was no statistical difference in effective rate between the positive EGFR and negative ones (P > 0. 05). Conclusion Neoadjuvant chemotherapy can significantly improve the expression of biological factors p53, Ki67, EGFR and nm23 in locally advanced breast cancer patients, and p53, Ki67 and nm23 have certain value in evaluating the curative effect of chemotherapy.