Younger patient age, larger tumor size, higher tumor grade, and positive nodal status are each associated with poorer prognosis, including the higher risk of distant recurrence, with lymph node status being the strongest contributor.1–3 In addition, positive hormone receptor status and HER2 status are both prognostic and predictive of treatment response.4,5 Patients with high-risk clinico-pathologic features—such as positive nodal status—are generally recommended to receive adjuvant chemotherapy. This evidence concerns the gene ERBB2 and neoplasm.