We previously reported that the PVN classification can accurately predict the outcome of patients with invasive ductal carcinoma in a manner that is independent of the nodal status or hormone receptor status (Hasebe et al, 2005), and the present study also clearly demonstrated that the modified PVN classification accurately predicted the outcome of patients with invasive ductal carcinoma in a manner that was independent of the nodal status, hormone receptor status, or adjuvant therapy status in a different group of patients with invasive ductal carcinoma. The gene discussed is NR4A1; the disease is invasive ductal breast carcinoma.