PD-L1 + associated with high tumor stage (stage 1 vs 2 vs 3 vs 4, 21.7% vs 21.9% vs 28.2% vs 34.0%, P = .015), lymph node metastasis (positive vs negative, 32.8% vs 27.9%, P = .007), estrogen receptor (ER) negativity (ER positive vs ER negative, 19.8% vs 26.8%, P = .000), human epidermal growth factor receptor 2 (HER2) positivity (HER2+ vs HER2, 30.3% vs 26.3%, P = .03), luminal B and TNBC molecular subtype (luminal A 24.7%, luminal B 29.7%, HER2-rich 22.6%, TNBC 26.8%, P = .043) and higher Ki-67 expression (low expression vs high expression, 21.5% vs 31.0%, P = .000). This evidence concerns the gene ESR1 and metastatic malignant neoplasm in the lymph nodes.