The observed higher expression of LDH-A has been previously found in less aggressive 67NR breast cancer cells under hypoxia in preclinical model16 and more differentiated tumours in patients with gastric cancer,32 while observed higher LDH-B in higher grade is in agreement with previous studies in breast cancer.33 However, carbonic anhydrase IX (CA9), a strong prognostic marker, has been recently shown to induce an acidic tumour extracellular pH in vivo,34 decoupling lactate production regulated by LDH and lactate concentration. This evidence concerns the gene CA9 and breast carcinoma.