In the study, we enrolled 150 breast cancer cases to investigate the expression status of activated leukocyte cell adhesion molecule (ALCAM), and the relationships between ALCAM expression and clinical-pathological characteristics and prognosis of breast cancer. It was observed that ALCAM was expressed at higher levels in breast cancer tissue compared to levels observed for tumor-adjacent tissue. Compared to cancers with low membranous ALCAM expression, cancers with high membranous ALCAM expression were prone to lymph node metastasis (χ2=15.910, P=0.010) and metastasis in general (χ2=5.211, P=0.029). High cytoplasmic ALCAM expression was noticeably correlated with local recurrence (χ2=7.379, P=0.012), especially for short-term recurrence (interval<2 years) (χ2=5.562, P=0.037), while not associated to long-term local recurrence (interval>2 years). The content of ALCAM protein is closely associated with the expression of estrogen receptor (ER) (P=0.024). The disease-free survival of patients with high cytoplasmic ALCAM expression was significantly shorter compared to the cases with low cytoplasmic ALCAM expression (P=0.036). In conclusion, ALCAM expressed at high levels in breast cancer. High membranous expression of ALCAM probably resulted in weakened adherent ability and metastasis. In addition, high cytoplasmic ALCAM expression strengthened invasive ability of malignant cells and then promoted tumor development.