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A consecutive series of 435 patients with breast cancer followed from six to thirty years is presented. Radical mastectomy was the surgical procedure of choice and our experience indicated that the degree of axillary nodal involvement is a most important guide in establishing prognosis in this disease. The majority of recurrences became evident within the first five postoperative years, the next most hazardous period for the patient being the half decade between the fifth and tenth years after initial therapy. A second independent malignancy developed in 37 of the 275 pateints who died, and it was the cause of death in 7.6 per cent of this group. Among the 160 patients still living to date a second independent malignancy has already developed in 10. Bilateral breast cancer was observed thirty-eight times in this entire series of 435 patients, an incidence of 8.7 per cent.