Importantly, a unique 186-gene invasiveness gene signature has been observed in CD44+/CD24- malignant cells,[22] linking the presence of CD44+/CD24- cells to distant metastasis although not to survival.[8,23] We found that the time to tumor relapse (including recurrence and metastasis) was significantly shorter in patients with than without CD44+/CD24- tumor cells. This evidence concerns the gene CD44 and neoplasm.