Objective To investigate the pattern of recurrence and metastasis of breast cancer in young patients and analyze the related factors. Methods The clinical and pathological data of 350 cases of breast cancer aged ≤ 40 years together with such prognostic data like the recurrence and metastasis and deaths were analyzed retrospectively. Results Median follow⁃up was 38.5 months，median disease⁃free survival（DFS）was 33 months， median visceral metastasis free survival（VFS）was 38 months，and median overall survival（OS）was 38 months. By Kaplan ⁃Meier analysis and Cox Regression Analysis，DFS were associated with the factors such as ER status （ER+/ER- = 0.102，P < 0.001），N stage（N1/N0 = 1.920，P = 0.044；N2/N0 = 2.546，P = 0.004；N3/N0 = 3.375， P < 0.001）and molecular types（Luminal B/Luminal A = 1.872，P = 0.084；overexpressed HER2/Luminal A = 0.327，P = 0.080；triple negative/Luminal A = 0.211，P = 0.017）and VFS were with such factors as ER status （ER +/ER- = 0.320，P < 0.001），N stage（N1/N0 = 2.596，P = 0.041；N2/N0 = 4.079，P = 0.004；N3/N0 = 8.021，P < 0.001）and age less than 35 years（the number aged less than 35 years/≥ 35 years = 3.337，P < 0.001）. OS was associated with such factors as N Stage（N1/N0 = 1.133，P = 0.802；N2/N0 = 2.114，P = 0.122；N3/N0 = 2.99，P = 0.014），neoadjuvant chemotherapy（those with neoadjuvant chemotherapy：HR = 2.389，P = 0.015）and ER status（ER+/ER- = 0.329，P < 0.001）. Conclusion Visceral metastasis of breast cancer in young patients is closely related to ER status，N stage and age.