Background: Locally advanced breast cancer is a frequent clinical entity that compromises a biologically heterogeneous group that can also be divided chronologically by the duration between onset of symptoms and presentation for medical care. Methods: Retrospective review of all patients with locally advanced breast cancer (LABC) treated in a general oncology practice between 1997 and 2007. Patients with LABC at presentation and have available follow-up were included. Patients were staged or restaged according to AJCC 7th edition. Patients were divided between two groups: those who presented within 3 months of onset of symptoms and signs of disease (non-neglected) and those who presented after more than 3 months (neglected). DFS was calculated from time of diagnosis till time of distant recurrence or last follow-up. Overall survival was calculated from time of diagnosis till time of last follow-up or death. Study was approved by IRB of the American University of Beirut. Data was entered and analyzed using SPSS. Survival was calculated and estimated according to Kaplan Meier method. Results: Total number of patients with LABC was 109 pts. Median age at diagnosis was 48 yrs (Range: 21-78 y). Hormone receptors were positive in 71% of cases. Number of neglected cases at presentation were 61 patients and non-neglected 48. Pre-operative therapy, adjuvant chemotherapy, hormonal therapy and radiation therapy were conformal with standard current guidelines. Neoadjuvant chemotherapy was given in 24% (27/109) of all cases. Adjuvant trastuzumab was used starting June 2005. Patients were followed closely every three months and compliance with therapy was excellent. Overall Survival (OS) of all patients was 68% at 5 years and 34% at 10 years. Median Survival was 100 months for non-neglected and 62 months for neglected disease (P: 0.06) Survival data Conclusions: Locally advanced disease confers a bad prognosis and poor outcome in patients with breast cancer. Patients who present within 3 months of onset of symptoms have a better survival than those who present with neglected disease. Neglected disease, even though not necessarily biologically aggressive, continues to have an adverse effect on survival. Survival continues to decline between 5 and 10 years. Additional patient demographics and tumor characteristics as well as shorter delays at presentation will be presented. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-11-17.