Given our findings of an increased rate of tumor growth with cold stress in the 4T1 murine TNBC preclinical model and the observed trend towards worse survival in high-thermogenesis TNBC, we expected that high thermogenesis would be associated with aggressive features of cancer including subtypes (ER-positive/Her 2-negative, Her 2-positive and TNBC), American Joint Committee on Cancer (AJCC) cancer staging, Nottingham histological grade (grades 1, 2, and 3), and MKI67 expression, which is a cell proliferation marker. The gene discussed is ESR1; the disease is cancer.