Ozmen et al. of Isanbul University, Turkey, reported that the false-negative rate of sentinel lymph node biopsy (SLNB) was higher in patients with initially axillary node-positive locally advanced breast cancer (LABC) before neoadjuvant chemotherapy, so patients with positive axillary lymph nodes still required axillary lymph node dissection before adjuvant chemotherapy. This study enrolled 69 patients with LABC who had positive axillary lymph nodes (N1 to 2 ) either clinically or on imaging. After neoadjuvant chemotherapy, all patients underwent SLNB followed by axillary lymph node dissection. The accuracy of SLNB after neoadjuvant chemotherapy for LABC was then assessed. The results showed that: The mean age was 46 years. The clinical stage before chemotherapy was 46% IIB, 22% IIIA, and 32% IIIB. Patients with positive clinical or X-ray suspicion of lymph nodes before neoadjuvant chemotherapy were diagnosed with axillary lymph node metastasis by ultrasound-guided aspiration cytology. Anterior lymph nodes were successfully confirmed in 58 cases (85%), with a false-negative rate of 17.4% for lymph node testing and 5 cases (9%) for pCR. Prior to neoadjuvant therapy, SLNB is the standard recommendation for patients with unclear axillary lymph node metastasis status because it allows selection of patients with negative axillary lymph nodes, for whom axillary lymph node dissection is not required, thus better protecting the function of the affected upper limb. However, in patients with positive axillary lymph node metastases before neoadjuvant chemotherapy, SLNB is equally important if axillary lymph node metastases become negative after neoadjuvant chemotherapy and axillary lymph node dissection should also be avoided. The results of this small sample study showed that the false-negative rate of SLNB after neoadjuvant chemotherapy was 17.4%, which was significantly higher than the false-negative rate of classical SLNB of less than 10%. Therefore, the clinical value of SLNB after neoadjuvant chemotherapy needs to be scientifically evaluated in a larger sample.