To evaluate the value of the clinical model for predicting axillary lymph node metastasis (ALNM) of breast cancer before operation by integrating ultrasound (US) and β-1,3-galactosyltransferase-4 (B3GALT4) expression level of the primary tumor. Here, B3GALT4 is linked to metastatic malignant neoplasm in the lymph nodes.