Lower serum albumin concentrations (⩽43 g l−1) were 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 ALB; the disease is neoplasm.