In a prospective blinded study, urine samples from 475 patients with gross hematuria collected at the time of standard urological examination (flexible cystoscopy and computed tomography urography) were tested for DNA mutation (TERT and FGFR3) and methylation biomarkers (SALL3, ONECUT2, CCNA1, BCL2, EOMES, and VIM) to determine whether a urine-based DNA test could replace flexible cystoscopy in the initial assessment of the most common BC symptom, i.e., gross hematuria. The gene discussed is TERT; the disease is breast cancer.