My breast care nurse told me that neoadjuvant chemo will hopefully shrink or kill the tumour itself, but that the important job is to kill any stray cells which might have gone walkabout elsewhere in the body. She told me that the cancer in my breast would not kill me, but that any cells from it going elsewhere, might well be a different story. Even if the main tumors or tumours don't show much shrinkage, I'm sure the chemo would still have helped greatly. The other advantage of chemo first, is that when the time comes for surgery, they know just where things are.