Hartmann et al. 2009 analyzed the performance of the PITX2 marker in 241 ER-positive, HER2-negative, and lymph-node positive tumor tissue samples showing that PITX2 promoter 2 (PITX2P2) hypermethylation was associated with a high risk of distant recurrence (time to distant metastasis) in the patient cohort (HR = 1.66; p = 0.002) and poor DFS (HR = 1.47; p = 0.0084) with the amplificate designed for the promoter of transcripts A and B of PITX2 (PITX2P2). This evidence concerns the gene ESR1 and neoplasm.