Background: With the advancement of breast cancer treatment, sentinel lymph node biopsy (SLNB) might take the place of conventional axillary lymph node dissection (ALND) in many clinical scenarios. Objective: The current study aimed to evaluate SLNB in patients with early-stage breast cancer (BC) whose axilla shown complete clinical and radiological response after neoadjuvant chemotherapy (NAT). Patients and Methods: The study included 96 patients with early BC and positive axilla showing complete clinical and radiological response after neoadjuvant therapy,and underwent SLNB before performing axillary lymph node dissection. Both specimens were examined by frozen section (for SLNB) and paraffin (for both specimens). Results: The mean age of the patients was 47.6 ±13.41 years. No significant difference was present when comparing the results of the frozen section of SLN, the paraffin section of SLN, and the paraffin section of the axilla as regards % of +ve and -ve cases. The specificity, negative predictive value, and accuracy between the frozen section and paraffin section (axilla) taking the paraffin section (SLN) as a gold standard were insignificant while the sensitivity of the frozen was significantly higher while the positive predictive value of the paraffin section (axilla) was significantly higher. Conclusion: SLNB can replace ALND in breast cancer patients with +ve axillary nodes without affecting the oncologic safety.