The status of axillary lymph nodes is the most important prognostic factor of breast cancer. The prognosis of node-positive breast cancer can be further subcategorized based on the number of involved lymph nodes. Most authors divide patients into those having 1 to 3, 4 to 9, and 10 cancerous nodes, with each successive level of nodal involvement entailing an increasingly poor prognosis. To evaluate the prognosis of breast cancer patients with ten or more positive lymph nodes, we performed a retrospective study in 53 cases of breast cancer patients with more than 10 positive lymph nodes who were treated from January, 1985 to May, 1996 and analyzed the 4-year survival rate and 4-year disease free survival rate between 23 patients with CMF adjuvant chemotherapy and 26 patients with Epirubicin plus CMF adjuvant chemotherapy. 5-year overall survival and 5-year disease free survival of 53 breast cancer patients with ten or more positive axillary lymph nodes were 35.8% and 30.3% respectively There was no statistically significant difference in the 4-year overall survival and 4-year disease free survival between 23 patients with CMF adjuvant chemotherapy and 26 patients with Epirubicin plus CMF adjuvant chemotherapy(OS;38.0% vs.64.7%;p=0.1148, DFS;26.0% vs. 32.3%;p=0.5660). In our study, the prognosis of 53 breast cancer patients with 10 or more positive axillary lymph nodes is poor. Therefore, further attempt such as high dose chemotherapy with autologous bone marrow transplantation will be needed.