PIP: In Manchester, England, the authors studied 175 women who had a Patey mastectomy with a full axillary dissection and in whom the histological status of the axillary nodes was known accurately. The mean length of follow-up was 34 months. Unlike workers from Liverpool, Edinburgh, and the National Cancer Institute, the authors found no difference between the recurrence rates of estrogen receptors, ER+ and ER- tumors in patients without axillary metastases. Others have reported similar findings. No difference was found in patients with extensive nodal disease. In patients with only 1-3 axillary nodes affected, a significant difference between the recurrence rates of tumors with and without ER was found. In these patients not only is recurrence less frequent in thos who have ER but also the frequency of recurrence for ER+ patients is similar to that in patients with no nodal metastases, regardless of receptor status. It could be argued that patients who have minimal axillary node involvement and who also have tumor ER should not be given chemotherapy, for they are no more at risk of recurrence than are node-negative patients. The wide spectrum of opinion of the value of estrogen receptors (ER) as a guide to prognosis serves to emphasize that any beneficial effect is at best marginal.