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Background: Axillary lymph node (ALN) status is one of the most important prognostic factors in early-stage breast cancer patients, as it implies the necessity of systemic adjuvanttreatment and locoregional irradiation.Axillary dissection (AD)contributes to improved local disease control and may increase survival.However,AD results in incidence of long-term side effects, particularly lymphedema.The purpose was to identify the independent predictive factors of axillary lymph node metastases (ALNM) in primary breast cancer patients.Methods: Univariate and multivariate regression analysis of age at diagnosis, menopausal status,tumor size,histopathological type, histological grade, ER, PR, HER-2, Ki67 and P53 status were considered as hypothetical predictors of ALNM in 7750 primary breast cancer patients which undergone axillary dissection (AD).Results: The menopausal status (p < 0.001), tumor size (p < 0.001), invasive duct carcinoma (P < 0.001),invasive lobular carcinoma (p =0.004), histological grade (p < 0.001), PR (p < 0.001) and Ki67 (p =0.042) were related to ALNM.But the ER, HER-2 and P53 status were not associated with ALNM (p >0.05).Conclusion: The menopausal status, tumor size, invasive duct carcinoma, invasive lobular carcinoma,histological grade, PR and Ki67 were independent predictive factors for ALNM in primary breast cancer, but the ER, HER-2 and P53 status were not associated with ALNM, which could be valuable in pre-operative patient discussions and the more efficient therapeutic approaches selection.