Background: Breast cancer (BC) is the most prevalent malignancy and the second major cause of cancer mortality among women globally. Metastatic BC is currently incurable. One of the current emerging studies is on pleiotrophin (PTN), a potent mitogenic cytokine associated with various types of cancer. PTN is also proven to be associated with BC metastasis through studies comparing PTN serum level of BC patients with and without metastasis, so this study aims to look at PTN expression in BC patient tissue. Materials and Methods: This observational cross-sectional study used PTN expression in BC tissue to assess immunohistochemical examinations. Histopathological grading of BC based on the Scarff-Bloom-Richardson modification. BC with or without metastases was defined with radiological evidence or clinical symptoms. PTN expression by immunohistochemical examination using the anti-goat polyclonal antibody in the breast tissue of BC patients. The principle of immunohistochemical evaluation was established on the Immunoreactive Score and was classified as high or low. Results: Of the 54 samples used in this study, metastasis was absent in 28 cases and present in 26 cases. The expression PTN is high in 24 patients with metastatic BC and in 4 BC patients without metastasis. A significant correlation was found between PTN level and metastasis (p <0.001). Conclusion: The study found a correlation between PTN levels and the occurrence of metastases in BC patients, indicating that elevated PTN levels correlate with increased distant metastasis risk.