Abstract: Objective : To investigate the predictive factors of metastasis in non-sentinel lymph nodes (SLNs) inbreast cancer patients. Methods : We identified SLNs by isotope. Besides routine H&E staining, serial sectionand immunohistochemistry were employed. Between May 1999 and July 2008, 108 patients had positiveSLNs verified by SLN biopsy. We reviewed the records of all these patients to explore the correlation betweenmetastasis in non-SLNs and clinicopathologic features in these patients. Results : The successful rate of SLNbiopsy was 96.0%, the sensitivity was 92.0%, the specificity was 100.0%, the false negative rate was 8.0%,the false positive rate was 0%, and the accuracy rate was 96.6%. The rate of metastasis in non-SLNs was66.7% (54/81) in patients with a primary tumor size >2 cm, 84.1% (37/44) in patients with the presence of lym-phovascular invasion, and 87.3% (55/63) in patients with the size of the largest SLN metastasis>2 mm. The14 patients with a primary tumor size>2mm, lymphovascular invasion and the size of the largest SLN metasta-sis>2mm presented with a metastatic rate of 100% in non-SLNs. Conclusion : The metastasis to non-SLNsfrom breast cancer is correlated with primary tumor size, size of the largest SLN metastasis, and presence oflymphovascular invasion.