Engel J, et al. - In view of the fact that the most significant clinical prognostic factor in breast cancer (BC) is the number of axillary positive lymph nodes (pLN), researchers intended to gain insight into LN-spreading and metastasization (MET). They examined 30,170 hormone receptor positive BC patients selected from the Munich Cancer Registry to determine the variation in tumor diameter and number of pLNs. A reduction in the probability of 0pLN-status by 1.6%–0.3% was induced by every additional millimeter of BC diameter. The proportion of 1–10 pLNs at 10 mm was 16% and raised to 50% with prognostically favorable 1-2pLNs of 75% and 40%, respectively. For 0pLNs, tumor-specific mortality was approximately 17% following 20 years and was twice that for 1pLN, and 3 times higher for 4–5 pLNs. The more LNs were positive, the less survival was influenced. Experts concluded that the number of pLNs represents an epiphenomenon of the start and chronometer for the duration of TCs disseminating from growing BCs. METs were started parallel to LNs by primary tumors (breast cancer) and not induced by pLNs. Generalizability of this LN process without cascade-like MET start, to all common solid tumors, was recommended.