148P Pattern of axillary lymph node involvement and scope of post neoadjuvant chemotherapy sentinel lymph node biopsy among breast cancer patients in developing countries

Breast cancer (BC) has emerged as a commonest in India. There is shift of transition from axillary lymph node dissection (ALND) to sentinel biopsy (SLNB). Recently SLNB emerging an option following neoadjuvant chemotherapy (NACT). To formulate policies for ALN management, we present our experience the pattern involvement among Indian BC patients and also assess scope LABC patients. This study conducted tertiary care center, North A prospective breast computerized data base was created captured 1992 2020. total 4186 ALNDs done were analyzed 1998 Mean age 48.5years. Stage-wise distribution where ALND 5.16% stage I, 41.92% II, 47.73% III 4.06% IV. Pathologic positivity seen 55.75% negativity 44.24% Among analyzed, 47.49% received NACT 52.5% had upfront surgery. who NACT, pathologic 59.95% 40.04% complete response (pCR) nodes. shows improves node-negative status. group, 53.78% negative with cN0, 39.74% cN1, 35.22% cN2 38.46% cN3. one largest series LMIC. Overall rates are high due heavy nodal burden disease at presentation. Results indicate that de-escalation axilla feasible approximately 40% undergoing NACT.