A number of previous studies have proposed biomarkers such as tumor size, nuclear grade, the presence of necrosis and expression of certain biomarkers such as HER2 overexpression, high proliferation (as detected using Ki67), p53 expression, and hormone receptor negativity in DCIS as risk factors for breast cancer recurrence [42, 43]. This evidence concerns the gene NR4A1 and ductal breast carcinoma in situ.