In a retrospective study of DCIS cases, DCIS lesions that were positive for p16, COX-2, and Ki67 expression were significantly associated with risk of subsequent invasive cancer whereas DCIS lesions that either lacked ER but were positive for ERBB2 and Ki67 or that lacked COX2 and were positive for p16 and Ki67 were associated with recurrence of DCIS [52]. The gene discussed is ESR1; the disease is ductal breast carcinoma in situ.