Multivariate analysis revealed that only NLR was a significant determinant of DFS and OS in all breast cancer patients (DFS, HR = 1.50 95% CI: 1.14–1.97, p = 0.004; OS, HR = 1.63, 95% CI: 1.07–2.49, p = 0.022) and in triple negative (negative for estrogen receptor, progesterone receptor, and human epidermal growth factor 2 receptor) breast cancer patients (DFS, HR = 2.58, 95% CI: 1.23–5.42, p = 0.012; OS, HR = 3.05, 95% CI: 1.08–8.61, p = 0.035) (106). This evidence concerns the gene ESR1 and breast cancer.