concurring in part and dissenting in part:
I agree with the majority that Dr. Lee’s alleged admissions to the Colberts were sufficient, even in the absence of expert testimony, to raise-a genuine issue of material fact as to whether Dr. Lee and Georgetown were negligent. I likewise have no particular problem with what my colleagues characterize as the “majority rule” in metastasis cases, insofar as that rule provides that the claim arises when the plaintiff knew or should have known that the defendant was negligent and that, as a result of that negligence, metastasis was likely to result. See, e.g., Johnson v. Mullee, 385 So.2d 1038, 1040 (Fla.Dist.Ct.App.1980). That doctrine is consistent with our rule that a medical malpractice claim does not accrue until the patient has “discovered or reasonably should have discovered all of the essential elements of her possible cause of action, i.e., duty, breach, causation, and damages.” Bussineau v. President and Directors of Georgetown College, 518 A.2d 423, 434 (D.C.1986) (quoting Ohler v. Tacoma General Hospital, 92 Wash.2d 507, 598 P.2d 1358, 1360 (1979) (en banc)). I part company with the majority, however, with respect to the application of that rule to the record in this case. In my opinion, the Colberts’ claim accrued, at the latest, in 1983, and is therefore time-barred.
I
The facts critical to the issue which divides the court were well stated by Judge Levie in his thoughtful opinion in the trial court. As the judge pointed out, the Col-berts were aware in 1982 that the cancer was all but certain to metastasize:
In October, 1982, Dr. Lee informed Ms. Colbert that she needed a mastectomy because the results of the biopsy showed “suspicious cells.” (Susan Colbert’s Inter.Ans. No. 11). At that time, Ms. Colbert asked him what the result of the delay had been or would be, and Dr. Lee told her that the delay [in performing the mastectomy] caused enhanced risk of a very high nature. (Susan Colbert Inter.Ans. No. 31). On October 21, 1982, after Dr. Lee performed a mastectomy of Ms. Colbert’s left breast, Dr. Lee spoke with Mr. Colbert and admitted that he (Dr. Lee) had performed the wrong operation, and that Ms. Colbert’s chances of surviving had been greatly reduced. (Edw. Colbert Depo. at 98). Before the operation, Dr. Lee told the Colberts that Ms. Colbert had a 90% chance of survival; after the mastectomy Dr. Lee told Edward Colbert that Ms Colbert had a 10% chance of survival. Basically, Dr. Lee said she was going to die. (Id.). At this point, plaintiffs were made aware of Susan’s injury (deprivation of her chances of recovery) and that Dr. Lee’s conduct constituted possible malpractice.
Memorandum Opinion, at 9.
Moreover, the metastasis which was discovered in 1986 was not by any means the only injury which the Colberts claimed to have incurred as a result of Dr. Lee’s and Georgetown’s negligence. As Judge Levie explained,
all of the other injuries that plaintiffs allege they sustained as a result of defendants’ negligence were sustained and occurred in 1982 and 1983. These injuries as elaborated by Ms. Colbert in her answers to interrogatories are as follows:
Third degree burns resulting from the otherwise unnecessary joint application of radiation and chemotherapy. Loss of body function and pain associated with otherwise unnecessary radiation therapy. Need for prophylactic mastectomy on the right side_ Additional chemotherapeutic and hormone treatment. Continued radiation to control pain and spread of disease. Emotional trauma to self, husband and children.
*1255(Susan Colbert Inter.Ans., No. 30). Mr. Colbert also testified at his deposition that in 1982-83 Ms. Colbert went through premature menopause, suffered nausea, dizziness and loss of hair, her bladder cracked and bled and she became extremely depressed. (Edw. Colbert Depo. at 135-142).
Id. at 12.
In their complaint, the Colberts sought to recover for these injuries even though they filed suit more than six years after Mrs. Colbert allegedly suffered them. It is in this factual context that the Colberts’ contentions must be considered.
II
In the cases relied on by the majority, the metastasis of the cancer was apparently the only injury for which the plaintiffs were seeking to recover. None of these decisions involved a situation in which the plaintiff was told, at a much earlier date, that metastasis and death were all but certain. In Johnson, swpra, for example, the Florida appellate court stated that
[a]t the time the radical mastectomy was performed, she had no cause of action against appellee doctor because there was no evidence that his alleged negligence had resulted in ang harm to her. It was only in February 1975, when the cancer appeared in other parts of her° body, that she discovered her cause of action.
385 So.2d at 1040 (emphasis added).
In the present case, on the other hand, the Colberts were told in 1982 that the probability of metastasis and early death had increased from 10% to 90% as a result of the defendants’ negligence. Moreover, Mrs. Colbert had complained, more than six years before suit was filed, of major injuries and suffering which had also allegedly been proximately caused by Dr. Lee’s and Georgetown’s malpractice.
These differences are critical and, in my view, dispositive. In order for her claim to have accrued, it is not necessary that Mrs. Colbert have learned with certainty that her cancer would metastasize as a result of the defendant’s negligence. See Baker v. A.H. Robins Co., 613 F.Supp. 994, 996 (D.D.C.1985). Since the Colberts knew in 1982 that there was a 90% probability of metastasis and death, they could have brought suit armed with .that probability, and they would have been entitled to “recovery of damages based on future consequences.” Wilson v. Johns-Manville Sales Corp., 221 U.S.App.D.C. 337, 345, 684 F.2d 111, 119 (1982).1 Assuming that the discovery of metastasis starts the clock running again in a situation where, at the time the plaintiff first knew or should have known of the defendant’s negligence, the possibility of such metastasis was at most speculative, such an assumption provides no solace to the Colberts where, as here, Dr. Lee told them in 1982, without contradiction, that there was a 90% probability that the cancer would spread and that Mrs. Colbert would die.
Moreover, as Judge Jackson, applying District of Columbia law, correctly pointed out in Baker,
[t]he fact that she did not then comprehend the full extent of all possible seque-lae does not matter, for the law of limitations requires only that she have inquiry notice of the existence of a cause of action for personal injury.
613 F.Supp. at 996 (emphasis in original; citations omitted). Put another way, “one who knows that [s]he has suffered from medical malpractice may not postpone an action until the full extent of [her] damage is ascertained.” Hulver v. United States, 562 F.2d 1132, 1137 (8th Cir.1977) (citations omitted), cert. denied, 435 U.S. 951, 98 S.Ct. 1576, 55 L.Ed.2d 800 (1978); see also Toal v. United States, 438 F.2d 222, 225 (2d Cir.1971).
This court has applied, in legal malpractice litigation, the principles articulated in Baker, Hulver, and Toal:
*1256It is not necessary that all or even the greater part of the damages have to occur before the cause of action arises. Any appreciable and actual harm flowing from the attorney’s negligent conduct establishes a cause of action upon which the client may sue.
Knight v. Furlow, 553 A.2d 1232, 1235 (D.C.1989) (emphasis added; citations and internal quotation marks omitted). We went on to note in Knight that “[t]he key issue is client knowledge of some injury, its cause, and related wrongdoing.” Id. at 1236 (emphasis added).
The Colberts’ reliance on Wilson, supra, 221 U.S.App.D.C. 337, 684 F.2d 111, is misplaced. In that case, the plaintiff, who had been exposed to asbestos products, developed mild asbestosis in 1973 and cancer in 1978. He died in 1978, and his widow filed suit for wrongful death in 1979. The court held that the one-year statute of limitations began to run with the discovery of the cancer in 1978, rather than with the appearance of mild asbestosis in 1973. The court reasoned that the more serious disease constituted a separate injury which was not predictable in 1973, and that Wilson could not have sought damages for cancer at that time.2 In the present case, on the other hand, the Colberts had been apprised of a 90% probability of metastasis and death. If they succeeded in proving what they alleged, any argument on behalf of the defense that the claimed damages were too speculative would have been demonstrably unavailing.3
The logic of the majority opinion in this case leads to the conclusion that Mrs. Colbert, knowing in 1982 that it was 90% probable that her cancer would have metastasized, could nevertheless sue in 1983 for burns, loss of body function, pain, a prophylactic mastectomy, emotional trauma, premature nausea, dizziness, hair loss, a cracked bladder, and severe depression, leave out of her suit any claim for metastasis, and then bring a separate suit in 1987 three years after the 90% probability had become a fait accompli No court, to the best of my knowledge, has ever reached a result like that!
III
Even if the allegations in the complaint with respect to the metastasis were not time-barred — and I have already expressed my disagreement with this premise — Dr. Lee and Georgetown would be entitled at least to partial summary judgment. I know of no principled argument for maintaining that the Colberts’ suit is timely with respect to those injuries which Mrs. Colbert is alleged to have suffered in 1982 and 1983. Counsel for the Colberts virtually conceded as much at oral argument, and there is nothing in counsel’s brief contrary to that near-concession.
IV
As Judge Levie observed in the introduc‘tion to his opinion, “this case is a difficult one, evoking much sympathy.” If the allegations of the complaint are true, then Dr. Lee was negligent, and the consequences for Mrs. Colbert were disastrous. Moreover, with the adoption and expansion of the discovery rule, see, e.g., Bussineau, supra, this court has tempered the rigors *1257of the statute of limitations, and has construed that statute in such a way that the reasonably vigilant plaintiff is accorded a fair opportunity to litigate the merits. We have never gone as far, however, as my colleagues take us today. The Colberts are being excused, in my view, for not asserting their rights in timely fashion after those rights had plainly ripened. From that portion of the majority decision, I respectfully dissent.
. “To meet the ‘reasonably certain' standard [for future consequences], courts have generally required plaintiffs to prove that it is more likely than not (a greater than 50% chance) that the projected consequence will occur.” Wilson, supra, 221 U.S.App.D.C. at 345, 684 F.2d at 119.
. The court pointed out in Wilson that only "15% of asbestosis sufferers later contract pleural mesothelioma and 12% contract peritoneal mesothelioma,” so that
it is altogether likely that had Wilson, upon receiving the “mild asbestosis” diagnosis, sought to recover for a cancer which might (or might not) develop, Johns-Manville would have argued forcibly that the probability of such a development was far less than 50%, and was therefore too speculative, conjectural, [and] uncertain to support a damage award.
221 U.S.App.D.C. at 346 & n. 45, 684 F.2d at 120 & n. 45.
. Counsel for Dr. Lee and Georgetown contended at oral argument that Wilson was incorrectly decided. Nothing in this opinion is intended to lend any support to that view, with which I emphatically disagree. The suggestion that the plaintiff should have lost his right to sue for cancer because he failed to sue for mild asbestosis, when the development of the cancer was not predictable, and when the plaintiff could not have recovered for it if he had brought the suit in 1973, has nothing to do with justice or with judicious statutory interpretation.