Women diagnosed with early-stage breast cancer now have access to important information about their prognosis, according to the authors of an article published in the Medical Journal of Australia on June 18. One in 10 Australian women diagnosed with non-metastatic breast cancer will develop metastases within five years, according to Dr Sarah Lord from the NHMRC Clinical Trials Centre at the University of Sydney and other co-authors. But if the cancer spreads to adjacent lymph nodes or adjacent tissue, the risk of metastasis rises to one in six. Researchers studied 6,644 New South Wales women diagnosed with non-metastatic breast cancer between 2001 and 2002 to determine how many of them developed metastatic cancer. They divided these women with non-metastatic breast cancer into two groups: limited (tumors that were lymph node negative and confined to breast tissue) and localized (tumors that spread to local lymph nodes or adjacent tissue). The overall risk of metastatic disease was 10 percent for both groups, but for the limited cancer group, the situation was much better: only one in 20 of them would develop metastatic breast cancer (MBC) within five years. The authors say their findings suggest that, in addition to relevant tumor biology, the spread of disease at the time of diagnosis is an important prognostic factor. In the paper, they write, “Clinicians can tell women with breast cancer about these predictive values for the average risk of developing MBC.” The women found to be at the highest risk of developing MBC in the study were those younger than 50 years of age and in low socioeconomic status. In addition, the risk of developing metastatic breast cancer was highest in the second year after the initial diagnosis of breast cancer. ”This information may give reassurance to women who have completed basic breast cancer treatment for more than 2 years and remain recurrence-free,” the authors wrote in the article. The authors also write that although the risk of MBC is one of the main concerns for women diagnosed with early-stage breast cancer, only a few population-based studies have explored the incidence of MBC in those initially diagnosed with non-metastatic breast cancer.