Abstract: OBJECTIVE To assess clinical application value, survivability, and the correlation to clinicopathologic factors of neoadjuvant endocrine therapy for postmenopausal breast cancer patients with ER(+) and/or PR(+). METHODS A total of 38 elderly patients with breast cancer were given letrozole for 3-12 months, 4 months in average，ER，PR，Her-2 and Ki-67 were detected before and after surgery, all patients were followed up for one to three years. RESULTS Clinical objective response is 68.4%. Sonography objective response is 55.3%. Complete remission achieved in 1 case (2.6%), partial remission in 26 cases(78.8%), no change in 6 cases(18.2%), the disease in 3 cases(7.9%) was progressed and changed into chemotherapy later. 33 cases(86.8%) were performed operation after treatment, 7 cases(21.2%) treated with BCS and 26 cases(78.8%)with mastectomy. There are no correlation found between response and the expression of HER-2. The expression of Ki-67 is remarkable decreased after treatment with letrozole (P<0.05). Several patients lose their ER or PR expressions after treatment. CONCLUSION Neoadjuvant endocrine therapy with letrozole for postmenopausal patients with receptor-positive breast cancer could effectively decrease or delay the advancement of tumor, the method is effective and safe, especially for elderly women whom are sickish and ineligible for radical mastectomy.