In the Carolina Breast Cancer Study (CBCS) phases I and II (1993-2001), we found that among HR+/HER2− patients, Black women had poorer breast cancer-specific and overall survival and, in phase III (2008-2013), were more likely to have aggressive intrinsic subtype (Luminal B, HER2-Enriched, and Basal-like), high-PAM50 assay risk of recurrence (ROR-PT) scores, and high tumor grade (3,9). The gene discussed is HR; the disease is breast cancer.