Objective To investigate the relationship between 18F-fluorodeoxy glucose (FDG) positron emission computed tomography (PET-CT) metabolism parameters and clinicopathological features of primary lesions of breast cancer. Methods The clinical data of 45 patients with breast cancer examined by 18F-FDG PET-CT and confirmed by surgery and pathology in the hospital from March 2013 to March 2018werecollected. Metabolism parameters such as the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG)of primary lesions of breast cancer and SUVmax of metastatic lymph nodes were determined. Results The 18F-FDGuptake of the 45 cases was relatively higher. The SUVmax, SUVmean, MTV and TLG of primary lesions were (4.88±1.52),(2.59±0.81),(8.19±2.51)cm3 and(21.96±6.42)g respectively. There were 28 cases with lymph node metastases, and the SUVmax of metastatic lymph nodes was (3.79±1.14). The SUVmax, MTV and TLG of primary lesions of breast cancer were significantly correlated with the maximum diameter, histological grade, T stage and lymph node metastasis (P<0.05). The TLG of ER-negative patients was significantly higher than that of ER-negative patients (P<0.05). The MTV and TLG of PR-negative patients were significantly higher than those of positive patients (P<0.05). There was no significant difference in SUVmax, MTV or TLG between HER-2 positive and negative patients or between p53 positive and negative patients (P>0.05). Spearman correlation analysis showed that the SUVmax of metastatic lymph nodes in breast cancer was positively correlated with the SUVmax, MTV and TLG of primary lesions (r=0.476, 0.469, 0.437, P<0.05), and positively correlated with Tstage (r=0.613, P<0.05). Conclusion There is a correlation between 18F-FDG PET-CT metabolism parameters and clinicopathological features of primary lesions of breast cancer, and the correlation of TLG is the most significant.