Sentinel lymph node biopsy (SLNB) is a procedure done for staging of tumor free axillary nodes in breast cancer patients but its use limited to early stages. Achievement of complete response after neo-adjuvant chemotherapy (NAC) evolving the reuse of SLNB in locally advanced breast cancer (LABC). Evaluation of the efficacy of sentinel lymph node biopsy in LABC patients with negative axilla after complete remission with NAC. A prospective study was carried out on 30 patients with LABC (T3-4, N0, and M0) whom received NAC. All cases underwent SLNB together with axillary clearance and surgical management of primary tumor. Identification of sentinel lymph node was achieved in 22 (62.7%) patients while not stained in 8 (37.3%) patients. The histopathology of SLNs and corresponding axillae showed that there is a statistical significance when SLNB used to evaluate the axillary status after neo-adjuvant chemotherapy with test sensitivity = 60%, specificity = 94.1%, PPV = 75%, NPV = 88.9%, and accuracy= 86.4%. After complete remission with NAC, when SLNB is negative the probability of metastasis in axilla is very low, so we can avoid axillary lymphadenectomy depending on the result of SLNB.
 

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