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The aim of this study is to investigate the association between plasma iron levels at diagnosis of early stage breast cancer and the risk of developing metastatic disease. In addition, a potential dependency on location of metastases and breast cancer subtype will be explored. A retrospective single-center approach was conducted on the database of the Multidisciplinary Breast Center of the University Hospital in Leuven. Patients newly diagnosed with stage I-III breast cancer between 2007-2017, whose serum iron, transferrin saturation and ferritin values were available within 1.5 months before or after diagnosis, were included in the study. Cox proportional hazard models were applied to determine the association between iron levels and risk of metastasis. 1113 patients were included, 10% of them developed distant metastasis. Transferrin saturation and serum iron were significantly associated with an increased risk of breast cancer metastasis. For each 10% increment of transferrin saturation, there was a 19% increase of metastatic risk (HR 1.19; 95% CI [1.02-1.38]). Similarly, a serum iron increment of 10 µg/dL led to a 6% increase in risk (HR 1.06; 95% CI [1.01-1.12]). Ferritin was found not to be associated with metastatic risk (HR 0.99; 95% CI [0.98, 1.01]). These results were adjusted for age, stage and subtype. However, there was no significant association with metastatic site or breast cancer subtype when adjusting for age and stage. We conclude that elevated transferrin saturation and serum iron at early breast cancer diagnosis are associated with increased risk for secondary metastatic disease. No association was found between iron levels and location of metastases or breast cancer subtype. Further research is needed to understand the underlying mechanisms and to explore the potential of iron-targeted therapies.