These findings were consistent with imaging assessments and postoperative pathological outcomes in patients who underwent neoadjuvant AC-T therapy.<h4>Discussion</h4>Our findings indicate that COL1A2 is associated with reduced chemotherapy sensitivity in HR+/HER2- breast cancer and may serve as a candidate biomarker to guide neoadjuvant taxane selection. Here, COL1A2 is linked to breast carcinoma.