الفهرس 
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Abstract
Purpose To evaluate axillary lymph node (ALN) response to anthracycline-based neoadjuvant chemotherapy (AB-NACT) in advanced non metastatic Breast cancer, using clinical examination , ultrasonography and ALD. Evaluating aforementioned tools as predicators of the state of ALN, in trial to raise the possibility of applying the concept of sentinel lymph node biopsy as a predicator of ALN.Patient and method Prospective study includes 50 female patients with locally advanced non metastic breast cancer . True cut biopsy of the primary tumor , fine needle aspiration cytology of ALNs to document nodal metastases performed before AB-NACT. Response of ALN assessed clinically and sonographically, followed by appropriate mastectomy procedure as dictated by each patient’s condition and ALND were done in all patients. Primary tumor and ALND specimens were submitted for pathological examination with additional immunohistochemical (IHC) section on negative ALN in some patients. Results Clinical, US and pathological complete ALN response (CR) to AB-NACT were encountered in 46%, 34%, 32% of patients respectively . US was found to be more sensitive than clinical examination in assessment of pathological response with a sensitivity , specificity and accuracy of 82.9%, 68.8% and 78.5%, respectively (p0.001).Conclusion Following AB-NACT in LABC, complete pathological response of the ALN is reasonable thus the need for ALND can be obviated. US and clinical examination assess and predict nodal response with accepted accuracy rate.