Objective To explore the predictive value of serum levels of nuclear receptor subfamily C member 2 (NR3C2), progesterone receptor membrane component 1 (PGRMC1), and carbohydrate antigen 153 (CA153) in predicting postoperative recurrence and metastasis in breast cancer patients. Methods A retrospective study was conducted on 102 breast cancer patients who underwent modified radical mastectomy at Nanyang Central Hospitall from January 2021 to January 2023. Patients were divided into two groups based on whether they experienced recurrence or metastasis one year after surgery: the occurrence group (38 cases) and the non-occurrence group (64 cases). Serum levels of NR3C2 and PGRMC1 were detected using ELISA, and serum CA153 levels were detected using immunochemical luminescence. The predictive value of serum NR3C2, PGRMC1, and CA153 for postoperative recurrent metastasis was analyzed using ROC. Results The postoperative serum levels of NR3C2 in the occurrence group were lower than those in the non-occurrence group, while the levels of PGRMC1 and CA153 were higher (P<0.05). Partial correlation analysis revealed that NR3C2 was negatively correlated with postoperative recurrence and metastasis, whereas PGRMC1 and CA153 were positively correlated (P<0.05). The AUC values for predicting postoperative 1-year recurrence and metastasis using serum levels of NR3C2, PGRMC1, and CA153, either individually or in combination, were 0.771, 0.775, 0.825, and 0.909, respectively, 2 months post-surgery. Notably, the AUC value for combined prediction was higher than that for individual indicators (P<0.05). Conclusion Serum NR3C2, PGRMC1, and CA153 have certain predictive value for postoperative recurrence and metastasis in breast cancer patients, and combined detection can improve the predictive efficacy.