Furthermore; the cancer specific survival was significant different between for low & intermediate groups and for high group stratified by PEPI-P score, and 80% cases were low & intermediate PEPI-P scoring groups.Our findings suggest that PEPI-P could be a potent tool for therapeutic decision-making regarding NAE-treated patients with ER-positive and HER2-negative breast cancer of the intermediate subtype. Here, ESR1 is linked to breast carcinoma.