The 5-year survival data for 62 patients with Stage I breast cancer treated at the University Hospital of the West Indies (UHWI) between 1982 and 1988 were evaluated to determine which factors were affecting outcome. The overall survival rates (66.7%) were below those quoted from large multicentre studies from North America, Western Europe and Australasia. The most significant survival differences emerged in the subset of postmenopausal patients with clinically staged disease who fared worse than those with pathologically staged disease. These data suggest that clinical staging is inadequate for the management of Stage I breast cancer. Consistent pathological staging, utilization of other prognostic predictors, and systemic therapy on a more widespread scale may help to improve the clinical outcome.