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Purpose To investigate the predictive value of systemic immune-inflammation-index (SII) and Pan-Immune-Inflammation-value (PIV) for axillary lymph node (ALN) metastasis in patients with breast cancer. Patients and Methods We retrospectively collected data of 247 patients with invasive breast from the Affiliated Hospital of Jiangnan University. The state of axillary lymph node (ALN) metastasis was confirmed by pathological diagnosis. Clinicopathological data (age, ER, PR, HER2, Ki67 expression levels, diapause status, weight, histological grade, vascular invasion, and state of axillary lymph node) were compared between differences of SII and PIV groups and an association between clinical indexes and ALN metastasis was evaluated. Results The cut-off values of SII and PIV were 320.04 and 92.01, respectively. The significant difference between vascular invasion ( P =0.023) and axillary lymph node metastases ( P <0.001) in the high and low SII levels. Significant differences were observed in tumor size ( p =0.024), PR expression level ( P =0.033) and the status of axillary lymph node metastases ( p <0.001) between the high PIV group and the low PIV group. Univariate analysis showed that vascular invasion, tumor size, Ki67 expression level, SII, and PIV were significantly correlated with axillary lymph node metastases ( p <0.05). Then, multivariate analysis revealed that the vascular invasion ( p <0.001), HER2 expression levels ( p <0.047), SII ( p <0.001) and PIV ( p <0.030) were risk factors for axillary lymph node metastases. Conclusion High levels of SII, PIV, LVI, and HER2 are the risk factors for axillary lymph node metastases in breast cancer patients.