Objective To study the relationship between the expression of p-AKT and HIF-1αprotein and the response of breast cancer to neoadjuvant chemotherapy.Methods A retrospective study was performed on 70 cases of breast cancer patients receiving 4-6 cycles of TEC neoadjuvant chemotherapy in Wenzhou people's hospital from January 2014 to December 2016.Immunohistochemistry was applied to the detection of p-AKT and HIF-1αexpression before chemotherapy.Neoadjuvant chemotherapy response was evaluated according to the postoperative pathology.Pathological response to G4 or complete response were considered to be response efficaciously.Chi-square test and Fisher's test were applied to analyze the correlation between these index and the efficacy of neoadjuvant chemotherapy.Results The response rate of neoadjuvant chemotherapy was 52.9%(37/70)among the 70 cases, among which the pathological complete response(PCR)was 21.4%(15/70).The positive expression of p-AKT and HIF-1α were 64.3%(45/70)and 61.4%(43/70)respectively.Statistical analysis shows that p-AKT and HIF-1α expression were associated with the response of neoadjuvant chemotherapy of breast cancer(P=0.002, P=0.035), and also associated with the PCR(P=0.001, P=0.015).Conclusion p-AKT and HIF-1αexpression in breast cancer reduce the sensitivity of neoadjuvant chemotherapy to breast cancer.Patient with negative expression may benefit more from neoadjuvant chemotherapy.