We found that high expression levels of SPEN (above the median cutoff) were predictive of early metastasis in two independent cohorts of 77 (HR 2.25, P = 0.03) and 170 (HR 2.23, P = 0.004) patients with HR-negative breast cancer (Fig. 5a and b) [32, 33]. The gene discussed is SPEN; the disease is breast cancer.