ESR1 and neoplasm: Due to the hard access to gene microarrays in clinical practice, a simplified immunohistochemistry (IHC) classification including estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), and Ki-67 index is now considered a surrogate for establishing breast cancer subtypes [15]–[18], which is essential to understand tumor biology, predict prognosis and make treatment decisions.