Importantly, in the multivariate analysis, when adjusted to tumor size, lymph node positivity, SBR grade, ER and PR status, TGFβ1 expression was still an independent predictor for distant metastasis (HR = 2.56, 95 % CI: 1.5 to 4.3, p < 0.0001) and death (HR = 2.06; 95 % CI: 1.13 to 3.75, p = 0.018). This evidence concerns the gene ESR1 and neoplasm.