Extracellular-regulated kinases (ERK1, ERK2) play important roles in the malignant behaviour of breast cancer cells in vitro. In our present study, 148 clinical breast cancer samples (120 cases with follow-up data) were studied for the expression of ERK1, ERK2 and their phosphorylated forms p-ERK1 and p-ERK2 by immunoblotting, and p-ERK1/2 expression in corresponding paraffin sections was analysed by immunohistochemistry. The results were correlated with established clinical and histological prognostic parameters, follow-up data and expression of seven cell-cycle regulatory proteins as well as MMP1, MMP9, PAI-1 and AP-1 transcription factors, which had been analysed before. High p-ERK1 expression as determined by immunoblots correlated significantly with a low frequency of recurrences and infrequent fatal outcome (P ¼ 0.007 and 0.008) and was an independent indicator of long relapse-free and overall survival in multivariate analysis. By immunohistochemistry, strong p-ERK staining in tumour cells was associated with early stages (P ¼ 0.020), negative nodal status (P ¼ 0.003) and long recurrence-free survival (P ¼ 0.017). In contrast, expression of the unphosphorylated kinases ERK1 and ERK2 was not associated with clinical and histological prognostic parameters, except a positive correlation with oestrogen receptor status. Comparison with the expression of formerly analysed cell-cycle-and invasion-associated proteins corroborates our conclusion that activation of ERK1 and ERK2 is not associated with enhanced proliferation and invasion of mammary carcinomas. Growth factors or cytokines exert positive and negative effects on cell proliferation and differentiation. After binding to their membrane receptors, the message is relayed to the nucleus by a complex system of intracellular signalling pathways. The majority of signalling molecules involved in these pathways are kinases, which are themselves activated by phosphorylation and repressed by their specific phosphatases. The mitogen-activated protein kinase (MAPK) signalling pathway includes a cascade of four groups of kinases (MAPKKKKs, MAPKKKs, MAPKKs and MAPKs). The MAPK kinase kinase kinases of the first level are phosphorylated in response to various extracellular stimuli through interaction with small GTP-binding proteins like Ras, Raf, etc. The activated enzymes then phosphorylate one of 14 kinases of the second level (the MAPKKKs, that is, Raf proteins, MEKK1-4, etc.), which themselves activate one of the MAPK kinases (MEK1 and 2, MKK3 -7) of the third level. Finally, these kinases (MAPKKs) activate MAP kinases, which are then able to phosphorylate transcription factors, which regulate the expression of genes involved in cell proliferation or differentiation. Three different, partly interacting signalling pathways have been identified in mammalian cells, leading to the activation of three types of MAP kinases: the MAP kinase JNK (Jun kinase) phosphorylates c-Jun, JunB, ATF2 and ELK1, etc., P38 activates ATF2, ELK-1 and MAX, whereas ERK1 and ERK2 phosphorylate...