ESR1 and breast carcinoma: Several lines of evidence indicate that MacroD1 is involved in several important signaling pathways: In breast cancer-derived MCF-7 cells, MacroD1 expression is induced by estrogenic hormones in an estrogen receptor alpha (ERα)-dependent manner and subsequently acts as a cofactor for ERα and the androgen receptor (Han et al. 2007; Yang et al. 2009).