ABSTRACT Background South-Asian women in Europe are significantly younger than non-Asian at diagnosis, present with larger tumours, and have higher mastectomy rates. In Australia, there is a paucity of data on early breast cancer in ethnic minority groups. The aim of this study is to examine racial differences in tumour characteristics and outcome in early node-positive breast cancer patients at Liverpool and Macarthur Cancer Therapy Centres in New South Wales (NSW), Australia. These tertiary centres service 20% of the NSW population, with 40% from a non-English speaking background. Methods A retrospective review of patients referred to Liverpool and Macarthur with node-positive non-metastatic breast cancer diagnosed before November 2006. Variables included tumour size, number of positive nodes, histological grade, hormone receptor status, age at diagnosis, country of birth and treatment. Outcome was disease-free survival. Women of Australian/New Zealand or European backgrounds were classed as Caucasian; women from Indian sub-continent, East Asia, South-east Asia, Middle East and Polynesia were classed as Asian. The study was approved by ethics. Results There were 644 patients, with median follow up of 6.1 years. The proportion of Australian/New Zealand, European, South/East/South-east Asian, Middle-Eastern and Polynesian populations comprised 48%, 20%, 12%, 6% and 2% respectively. Women with Asian backgrounds were significantly younger at presentation (48 vs 55 years), and more likely to undergo mastectomy (46% vs 34%) and chemotherapy (82% vs 68%) than non-Asians. Tumour grade, stage and receptor status were not statistically different between the two groups. Median age, tumour size, number of nodes involved, disease-free survival and overall survival, respectively, was 52.5 years, 22mm, 2/19, 148 months and 177 months. Multivariate analysis identified risk factors of tumour size > 2cm (hazard ratio HR = 1.51, confidence interval CI 1.06-2.41, p value 0.02), > 10 lymph nodes involved (HR = 2.64, CI 1.75-3.98, p-value Conclusion Characteristics and outcome in our cohort are consistent with the literature. The Asian ethnic minority population had a younger age at diagnosis, higher mastectomy and adjuvant chemotherapy rates. Disclosure All authors have declared no conflicts of interest.