In addition, DCISM was associated with more aggressive tumor characteristics like ER negative (33.1% vs. 17.5%; P < 0.001), PR negative (44.9% vs. 27.3%; P < 0.001), HER2 positive (36.5% vs. 32.4%; P = 0.009) and lymph node metastasis (7.6% vs. 0%; P < 0.001). This evidence concerns the gene ESR1 and metastatic malignant neoplasm in the lymph nodes.