Breast cancer treatment is individualized and your medical oncologist will look at things such as the size of your tumor, grade of your tumor, the hormone receptors of your tumor, your age, and if there is lymph node involvement to determine if you will need chemotherapy. The goal of chemotherapy is to reduce the risk of cancer coming back. Chemotherapy given before surgery is called neoadjuvant chemotherapy. Your doctor may choose this approach if you have been diagnosed with a locally advanced breast cancer, a triple negative breast cancer, a Her 2 positive breast cancer, or an inflammatory breast cancer. Also, if you have a large breast cancer and want to conserve your breast (lumpectomy), chemotherapy may be given to shrink the tumor before surgery. Shrinking the tumor (or downstaging) allows for less extensive surgery, meaning you may be able to avoid having a mastectomy and/or have a lot of lymph nodes removed in the axilla. Patients with tumors that are small (less than 2 centimeters), low grade, estrogen positive, or Her2-negative may not require systemic chemotherapy and will likely be recommended to have surgery first.