Objective:To investigate the expressions of plasminogen activator inhibitor type 1 (PAI-1), C-erbB-2, VEGF and Ki-67 by immunohistostaining and then to evaluate the prognostic value of PAI-1 in node-negative breast cancer. Methods:The study included a retrospective series of 62 female patients with axillary lymph node-negative breast cancer. Expressions of PAI-1, C-erbB-2, VEGF and Ki-67 were determined by immunohistostaining on formalin-fixed paraffin-embedded tissue sections from these patients after a median follow-up of 69 months (range 22–117 months). Correlations with well known clinicopathologic factors were assessed and multivariate survival analyses were performed. Results: High PAI-1 level was positively associated with high histologic grade of the tumors. Disease-free survival (DFS) was significantly shorter for the patients with moderate to intensive expression of PAI-1 than for those with negative (χ2 = 25.46, P < 0.001; χ2 = 23.07, P < 0.001) to mild expression (χ2 = 19.75, P < 0.001; χ2 = 17.40, P < 0.001). Although on univariate analysis of the prognostic factors, tumor size, location of primary tumor and age as well as expressions of PAI-1, VEGF and Ki-67 were all significantly prognostic factors for DFS (P < 0.05), PAI-1 was the only independent prognostic factor on multivariate analysis (P<0.0001; hazard ratio [HR], 4.041; 95% confidence interval [CI], 1.928–8.468). Conclusion: These results of the current study indicate that intermediate or high expression of PAI-1 represents a strong and independent unfavorable prognostic factor for the de-velopment of recurrence or metastases in axillary node-negative breast cancer. Objective: To investigate the expressions of plasminogen activator inhibitor type 1 (PAI-1), C-erbB-2, VEGF and Ki-67 by immunohistostaining and then to evaluate the prognostic value of PAI- 1 in node-negative breast cancer. Methods Expressions of PAI-1, C-erbB-2, VEGF and Ki-67 were determined by immunohistostaining on formalin-fixed paraffin-embedded tissue sections from these patients after a median follow-up of 69 months (range 22-117 months). Correlations with well known clinicopathologic factors were assessed and multivariate survival analyzes were performed. Results: High PAI-1 level was positively associated with high histologic grade of the tumors were significantly shorter for the patients with moderate to intensive expression of PAI-1 than for those with negative (χ2 = 25.46, P <0.001; χ2 = 23.07, P <0.001) to mild expression (χ2 = 19.75, P <0.001; χ2 = 17.40, P <0.001). Although on univariate analysis of the prognostic factors, tumor size, location of primary tumor and age as well as expressions of PAI-1, VEGF and Ki-67 were all significantly PAI-1 was the only independent prognostic factor on multivariate analysis (P <0.0001; hazard ratio [HR], 4.041; 95% confidence interval [CI], 1.928-8.468). Conclusion: These results of the current study indicate that intermediate or high expression of PAI-1 represents a strong and independent unfavorable prognostic factor for the de-development of recurrence or metastases in axillary node-negative breast cancer.