This is the first of a two-part conference report and focuses primary on newer technologies (e.g., molecular methods for intraoperative nodal assessment and MRI/PET imaging) and surgical management in the context of neoadjuvant chemotherapy. A notable feature of the Second Kyoto Breast Cancer Consensus Conference was a consensus session for which a series of key clinical questions in the aforementioned areas formed the basis for discussion. Preconference questionnaires had been issued to all delegates and the final consensus sessions focused on more controversial and problematic areas where there is divergence of opinion and clinical management.