Abstract: Anthracyclines occupies an important position in the neoadjuvant and adjuvant chemotherapy for breast cancer treatment. As the molecular target of Anthracyclines, whether TOP2A can act as a reliable biomarker predictive of chemosensitivity in breast cancer patients treated with anthracyclines has excited considerable interest in research. This review focuses on the predictive value of TOP2A for anthracycline efficacy and its impact on the prognosis of patients with breast cancer at three different levels of gene status, mRNA and protein expression.