Records of 215 patients receiving radical mastectomies from 1958 to 1968 at Roswell Park Memorial Institute were reviewed for the significance of axillary nodal status on long-term survival and recurrence. Ten-year disease-free interval rates were 83%, 47%, and 17%, respectively, for patients with negative nodes, 1-3 positive nodes, and greater than or equal to 4 positive nodes. Fifteen-year rates were 80%, 37%, and 8%, respectively. Survival and disease-free interval curves for the 3 nodal status groups were significantly different from each other (P less than 0.0001). Curves for three subclasses of the greater than or equal to 4 positive node group (4-6, 7-12, and greater than or equal to 13) were similar in overall survival, but were significantly (P = 0.04) different for disease-free interval, due to a rapid rate of recurrence in the greater than or equal to 13 positive node group. Hazard rates of treatment failure during each successive 3-year period for 9 years following mastectomy for those with 1-3 positive nodes or greater than or equal to 4 positive nodes decreased with time, whereas the rates for those with negative nodes were low and relatively constant throughout follow-up. These findings support the thesis that a significant proportion of negative nodes patients are cured by mastectomy and that a smaller group of node-positive patients have regional disease with a chance of cure by mastectomy.