Abstract: OBJECTIVE To compare the clinical efficacy, prognosis and safety of different neoadjuvant chemotherapy (NACT) regimens in operable triple negative breast cancer(TNBC) and to explore its relationship with breast cancer susceptibility gene BRCA1. METHODS A total of 120 patients with operable TNBC admitted to Huizhou Central People's Hospital from January 2014 to August 2016 were enrolled as research subjects in the study. They were divided into two groups according to the random number table: TP(docetaxel+carboplatin) group and TAC(docetaxel+doxorubicin+cyclophosphamide) group, 60 cases in each group. Before surgery, all patients were given NACT, TP group was given docetaxel and carboplatin; TAC group was given docetaxel, doxorubicin and cyclophosphamide; after surgery, gene chip method was used to detect mutation of tumor tissue BRCA1 in all patients. All patients were followed for 3 years. The clinical efficacy and prognosis of the two groups were compared and analyzed for their relationship with BRCA1 mutation and toxic side effects. RESULTS Compared with the TAC group, the proportion of pathological complete response(pCR) rate and overall rate(ORR) in the TP group was significantly higher(P<0.05). There was no significant difference in disease-free survival(DFS) and disease-free survival between the two groups for 3 years. In 120 cases of operable TNBC patients, there were 14 cases in BRCA1 mutation group and 106 cases in BRCA1 wild group. Compared with BRCA1 wild group, the proportion of pCR and ORR in BRCA1 mutation group increased(P<0.05). The 3-year DFS and disease-free survival rates of the BRCA1 mutation group were (38.34±1.48)months and 85.7%, respectively. The 3-year DFS and disease-free survival rates of the BRCA1 wild group were (34.50±0.62)months and 82.1%, respectively. There was no significant difference in DFS and disease-free survival rates between the two groups. Compared with the TAC group, the incidence of hematological toxicity and liver function damage in grades 3-4 of TP group was significantly decreased, and the incidence of gastrointestinal function was increased(P<0.05). There was no significant difference in the incidence of leukopenia and renal dysfunction. CONCLUSION Compared with TAC regimen, TP regimen can effectively improve the clinical efficacy of operable TNBC patient. The BRCA1 mutation group has higher clinical efficacy, but it can not improve disease-free survival rate, and does not increase the safety risk of patients. It has guiding significance for clinical treatment.