However, a recent meta-analysis of long-term outcomes of 21,457 women with early stage breast cancer in 20 randomized trials of adjuvant tamoxifen identified ER expression as the sole pathological factor predictive of response with no significant independent contribution by PR (relative risk of recurrence following tamoxifen treatment as compared with placebo or observation was 0.63 (SE 0.03) in the ER+/PR+ group and 0.60 (SE 0.05) in the ER+/PR- group) [14]. This evidence concerns the gene ESR1 and breast carcinoma.