686 Background: Due to regional differences in environment, lifestyle, social-demographic structure and ethnicity, the presentation and outcome of breast cancer in India may be different from that in developed nations. To gain further insight, we retrospectively reviewed the clinical presentation and outcome of EBC patients and conducted survival analysis based on various features. Methods: During the period 1993 through 1999, 487 women with EBC, treated at our institute, were analyzed. Cox's multivariate regression analysis was used to find prognostic factors significant for overall (OS) and disease-free survival (DFS). Results: The median age at presentation was 47 years (range 23–82), 49.7% were pre-menopausal. When first seen, 96% of the patients had a lump, with 7.8% in clinical stage I, 38.8% stage II a, 47.6% stage II b, and 4.3% stage III. Only 11.3% opted to undergo breast-conserving surgery (BCS) while rest 88.7% had modified radical mastectomy. Adjuvant chemotherapy was administered to 275 women (56.5%), CMF; 250, FEC; 25, and radiotherapy (RT) to 146. Since estrogen receptor status was known for only 173 women (93 positive), most were prescribed tamoxifen 20mg per day for at least 5 years. Ovarian suppression was performed in 62 premenopausal women, by surgery in 34 and RT in 28. At a median follow up of 48 months, 126 (25.9%) patients relapsed (local-regional 19,distant 107) and 94 (19.3%) died. Five year DFS and OS for whole cohort were 73% and 78% respectively; corresponding figures for stage I being 88% and 91%, stage IIA 78% and 82%, and IIB 64% and 72%, respectively. On multivariate analysis, number of lymph nodes involved (4 or more) was the only significant prognostic factor for both DFS and OS (p<0.01), others like age, tumor size and stage being non-significant. Conclusions: Significant differences in EBC presentation in India versus West were noted. The median age at presentation is a decade lower. Due to limited mammography facilities for screening, majority presents with palpable lump, in stage II. The preference for BCS is still very low. The treatment results stage wise are however similar. No significant financial relationships to disclose.