Histologically, a higher nuclear grade (P = 0.001), larger pathologic tumor size of the surgical specimen (P < 0.001), negative ER (P < 0.001), negative PR (P < 0.001), positive HER2 (P < 0.001), and high Ki-67 level (P < 0.001) were significantly more frequent in the groups with upgraded lesions. This evidence concerns the gene ESR1 and neoplasm.