Background: Recurrence of cancer breast is a major problem during the first 2 years after diagnosis in addition to selection of adjuvant regimen is based mainly on the axillary lymph nodes stage. So, cost-effectively, patient will save much amount of budget needed for detection of gene expression. This study evaluates axillary lymph nodes dissection in prognosis of HER2-positive breast cancer. Patients and methods: The current study analyzed 100 patients complained breast cancer. There were two types of surgery performed; MRM in 46 cases (46%) when there were con traindications of BCT or patients preferred radical surgery and BCT in 54 cases (54%) when indicated. Follow-up was for 2 years. Results: All cases passed operation without mortality. Recurrence was reported in ten patients (10%). Six patients (6%) died during their follow up due to distant metastasis. All recurrent patients having grade N3 >9 positive lymph nodes; P-value; 0.0001. There was statistical significance between nodal status and tumor size; KW test & P; 8.08 & 0.044 (S) respectively and between Histopathology and Nodal status; FET & P; 5.96 & 0.031 (S) respectively. Conclusion: Positive or negative axillary lymph nodes are considered the most important predicting factor for recurrence and overall survival of HER2-positive patients complained breast cancer. Moreover worsening prognosis is closely related to which group positive and the number of affected lymph nodes.