Reviewing the axillar lymph node status in 196 consecutive breast cancer patients and comparing clinical assessment to pathological findings, the author found an overall erroneous appraisal of 39% with 45% false negative and 29% false positive cases. In more than 15% of the cases there were skip metastases. In the T1 group, stratification to the greatest diameter of the tumor gave a significant difference (P less than 0.01) between axillar LNI in tumours smaller or equal to 1 cm and those with a diameter between 1 and 2 cm. Lymph node metastases in the interpectoral space is extremely rare (less than 0.5%) and always macroscopic. Axillar lymph nodes were always invaded in T4 tumours. The author warns against clinical studies based upon clinical assessment of the axillar lymph node status. He advocates a complete axillar lymph node dissection in all cases. He suggests that the T1 classification should be restricted to tumours with a diameter smaller or equal to 1 cm.