ESR1 and neoplasm: Tamoxifen treatment was associated with a strongly reduced risk of distant recurrence in the group of patients with ER-positive/PgR-positive tumour and low cytoplasmic 4EBP1 (distant recurrence-free survival: hazard ratio (95% confidence interval) = 0.19 (0.09 to 0.42), P = 0.00003; Figure 6a), whereas no significant benefit from tamoxifen could be seen in the 4EBP1 high cytoplasmic group (distant recurrence-free survival: hazard ratio (95% confidence interval) = 0.60 (0.30 to 1.23), P = 0.17; Figure 6b).