Background: It is well established that mutations in the BRCA1 gene are a major risk factor for breast cancer. Induction of cancer cell death and inhibition of survival are the main principles of cancer therapy. In this context, autophagy may have dual roles in cancer, acting on the one hand as a tumor suppressor and on the other as a mechanism of cell survival that can promote the growth of established tumors. Therefore, understanding the role of autophagy in cancer treatment is critical. Moreover, defects in apoptosis, programmed cell death, may lead to increased resistance to chemotherapy. Purpose: The aim of the present study was to detect BRCA1 gene mutations in order to throw more light on their roles as risk factors for breast cancer in Egypt. Secondly the role of autophagy and apoptosis in determining response to a fluorouracil, doxorubicin, cyclophosphamide (FAC) regimen was investigated. Materials and Methods: Forty-five female breast cancer cases and thirty apparently healthy females were enrolled in the present study. Serum levels of autophagic biomarkers, Beclin 1 and LC3 as well as the serum levels of apoptosis biomarkers Bcl-2 and Caspase-3 were measured before and after chemotherapy. Results: BRCA1 mutations were found in 5 (16.7%) and 44 (99.8%) of the controls and cancer patients, the most frequent being 5382insC followed by C61G and 185 delAG. The results revealed that chemotherapy caused elevation in serum concentration levels of the autophagic biomarkers (Beclin 1 and LC3). This elevation was associated with a significant decrease in serum concentration levels of Bcl-2 and significant increase in caspase-3 concentration levels (apoptotic markers). Several factors may be responsible for the development of breast cancers, where they fall into modifiable and non-modifiable factors. Modifiable factors include; socioeconomic status, radiation exposure, modifiable hormonal factors such as hormone replacement therapy and lifestyle factors such as obesity and cigarette smoking. Non-modifiable risk factors include, age, reproductive factors, family history of breast disease and genetic predisposition (Lakshmi et al., 2013). However, genetic factors are thought to contribute to approximately 5% of all breast cancer cases, but to 25% of cases diagnosed before age 30 years. There are several breast cancer susceptibility genes that have been identified. These genes include in the first degree BRCA1 and BRCA2, and other tumor suppressor genes (TSGs) to a lesser extent, such as p53 (Tam 2010). Mutations of genes BRCA1 and BRCA2 involved in breast cancer susceptibility are Mohamed Ahmed Abdel-Mohsen et al