Although some scoring systems, such as the H-score, Allred Score etc, have attempted to incorporate both tumor cell staining percentages and nuclear staining intensity of estrogen receptor (ER) and progesterone receptor (PR) into a single total score in breast cancer, the IHC nuclear scoring analysis algorithm has not yet been fully optimized for dissimilar biomarkers on various tissue types. This evidence concerns the gene ESR1 and breast carcinoma.