ABSTRACT Background: Axillary lymph node metastasis is the key on treatment and prognosis of breast cancer. Objective: This study aimed to reduce the risk of unnecessary axillary lymph node dissection in female breast cancer finding the relation between size of tumor and axillary lymph node metastasis. Patients and methods: This study included 41 female patients with operable breast cancer who were admitted to General Surgery Department, Zagazig University Hospitals. The patients were divided into two groups where group I included 17 patients with breast mass ≤ 2 cm and group II included 24 patients with breast mass > 2 cm. Results: Breast lump was the major symptom complained by 41 patients (100%). Followed by axillary lump 22% and breast pain 22%. Left breast was the most commonly affected side with 21 patients (51.2%) and the upper outer quadrant was the most affected quadrant with 23 patients (56.1%). All patients had infiltrative duct carcinoma. 30 patients (73.2%) had infiltrative duct carcinoma grade II but only 11 patients (28.8%) had infiltrative duct carcinoma grade III. 39 patients (95.1%) underwent modified radical mastectomy and 2 patients (4.9%) underwent radical conservative breast surgery after fulfilling the criteria making them candidates for breast conservative surgery. There was no local recurrence in both groups during a follow up period up to six months. Conclusion: There was no correlation between breast cancer mass size and axillary lymph nodes involvements. There was direct proportion between tumor size in cancer breast and number of axillary lymph nodes involvement when there is metastasis in axillary lymph nodes.