Abstract: Objective:To investigate the relationship between mammographic features and human epidermal growth factor receptor 2(Her2)as well as E-cadherin and their diagnostic efficacy in axillary lymph node metastasis of breast cancer.Methods:80 breast cancer patients admitted to Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China from June 2017 to June 2022 were selected and divided into metastatic group (n=38) and non-metastatic group (n=42) according to the presence or absence of axillary lymph node metastasis on surgical pathology.The mammography features of the two groups and the expressions of Her2 and E-cadherin in patients with different features were compared, and multivariate logistic regression analysis was conducted to analyze the relationship between mammographic features and axillary lymph node metastasis, and to analyze the diagnostic efficiency of mammographic features.Results:The positive expression rate of Her2 was higher in the metastatic group than in the non-metastatic group, and the positive expression rate of E-cadherin was lower than in the non-metastatic group(P< 0.05); the positive expression rate of Her2 was higher in patients with marginal burr, calcified features, structural distortion, lymph node enlargement and no lymph node fatty infiltration than in patients with no marginal burr, no calcification, no structural distortion, no lymph node enlargement and lymph node fatty infiltration(P< 0.05); the positive expression rate of E-cadherin was lower in patients with marginal burr, thickened and increased vessels, calcification, structural distortion and no fatty infiltration of lymph nodes than in patients with no marginal burr, normal vascular signs, no calcification, no structural distortion and fatty infiltration of lymph nodes(P< 0.05).In the metastatic group, there were more patients with ≥2 cm in size, marginal burr, thickened and increased vessels, structural distortion, and lymph node enlargement than in the non-metastatic group, and fewer patients with fatty infiltration of lymph nodes than in the non-metastatic group (P< 0.05); multivariate logistic regression analysis showed that size ≥2 cm, marginal burr, thickened and increased vessels, structural distortion, lymph node enlargement, and fatty infiltration of lymph nodes were all relevant influencing factors for axillary lymph node metastasis(P< 0.05).The sensitivity, specificity, positive predictive value, negative predictive value and Jorden index of the combined mammographic features for the diagnosis of axillary lymph node metastasis were the highest, which were 94.74%, 92.86%, 92.31%, 95.12% and 0.8760, respectively.Conclusion:Mammography of breast cancer with a size of ≥2 cm, marginal burr, thickened and increased vessels, structural distortion, lymph node enlargement, and fatty infiltration of lymph nodes are associated with axillary lymph node metastasis, and some of these features can reflect the expressions of Her2 and E-cadherin.The combination of the obove features can provide references for the diagnosis of axillary lymph node metastasis and the assessment of Her2 and E-cadherin expressions, which can help the clinical follow-up to formulate a reasonable diagnosis and treatment plan.