Aim:The status of axillary lymph node metastasis (ALNM) at diagnosis has been considered as one of the most important prognostic factors for overall and disease-free survival in patients with breast cancer. Determination of breast cancer patients at risk for ALNM is important for treatment planning. The purpose of this study was to determine the factors that affect axillary lymph node involvement in breast cancer in addition to biological and pathological parameters to prevent unnecessary lymph node dissections.Methods:Immunohistochemical and pathologic features of 131 breast cancer patients, who underwent breast surgery, were investigated retrospectively.Results:ALNM was detected in 60% (n=79) of patients. In univariate analysis, histological grade, tumor size, lymphovascular invasion, perineural invasion, HER2 positivity and large intraductal component were found to be high risk factors for ALNM. In multivariate analysis, increased tumor size (T1; OR: 0.2, p<0.034) and presence of lymphovascular invasion (OR: 0.2, p<0.001) were found to be independent factors for ALNM.Conclusion:In our study, presence of lymphovascular invasion and increased tumor size were found to be independent predictive factors for axillary lymph node involvement. In univariate analysis, histological grade, tumor size, lymphovascular invasion, perineural invasion, HER2 positivity and large intraductal component were found to be high risk factors for ALNM. Patients carrying these factors may be included in the higher risk group for lymph node involvement. However, more data is needed to identify the factors that may help to decide for axillary lymph node dissection.