A lower serum albumin concentration (⩽43 g l−1) was associated with deprivation (P<0.05), hormonal receptor negative tumours (P<0.01) and significantly poorer 3-year relapse-free (85 vs 93%, P=0.001), cancer-specific (87 vs 97%, P<0.0001) and overall survival (84 vs 94%, P=0.001) rates. The gene discussed is NR4A1; the disease is cancer.