To investigate the prognostic value of circulating tumor cells（CTCs）in patients with stage T_1-2 breast cancer with 1~3 positive axillary lymph nodes（ALNS）.

Clinical data of 120 patients with breast cancer who met the standards from January 2016 to December 2019 were retrospectively analyzed. SPSS24.0 statistical software. was used for analysis. Univariate and multivariate analysis of patient prognosis was performed by COX risk regression model. ROC curve is drawn to determine the optimal critical value of CTCS. Kaplan-Meier method was used to draw disease-free survival curves of patients with different CTCS levels，and log-rank test was used to analyze the difference in survival rates. P<0.05 was considered statistically significant.

The follow-up period was 27~63 months，with a median of 49 months. No patient died during the follow-up period，a total of 10 patients had local recurrence，5 patients had distant metastasis，and 1 of them had local recurrence with distant metastasis. The 5-year DFS was 88.3%.Cox univariate survival analysis showed that age，PT2 stage，triple negative molecular typing and CTCS number were the influential factors for postoperative prognosis（P<0.05）. ROC curve analysis of CTCS showed that the AUC was 0.807（95%CI：0.739-0.875），the optimal cut-off value was 3，the Youden index was 0.683，the sensitivity was 0.908，and the specificity was 0.775.During the follow-up period，10 of the 71 patients in the CTCS≥3 group had recurrence and metastasis，the 5-year disease-free survival rate was 85.9%，and 4 of the 49 patients in the CTCS<3 group had recurrence and metastasis，the 5-year DFS was 91.8%. The difference in DFS between the two groups was statistically significant（χ²=4.006，P=0.045）.

CTCS can predict the prognosis of breast cancer patients with stage T_1-2 and 1~3 p ALNs positive patients. When patients have CTCs≥3，PMRT should be considered in combination with other clinicopathological characteristics such as age，PT stage，molecular typing to improve the prognosis of patients.