Objective: This study aims to investigate the correlation and clinical significance of hormone receptors and the expressions of HER-2 and Ki-67 in breast cancer primary lesions and lymph node metastatic tissues. Methods: 83 cases were studied, who were performed breast cancer surgeries and confirmed the ipsilateral axillary lymph node metastasis by the postoperative pathological diagnosis. Immunohistochemical method was used to simultaneously detect the expressions of ER, PR, HER-2 and Ki-67 in the primary lesions and lymph node metastases. Results: ER exhibited the expression concordance rate as 85.5% in primary lesions and metastases, with significant difference (P = 0.039); the expression concordance rates of PR and HER-2 in primary lesions and metastases were 90.4% and 89.2%, respectively, without significant difference (P = 0.289, 0.180); between the Ki-67-highly-expressed primary lesions and Ki-67-lowly-expressed metastases, the expressions of ER in primary lesions and metastases exhibited statistical significance, with P as 0.031. Conclusions: The primary lesions and lymph node metastases had higher consistency, while there was still about 10% patients showed differentiated expression. The simultaneous detection of breast cancer primary lesions and lymph node metastases was still very necessary.